Sandbox:AA

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Management of ongoing Orthodromic AVRT

Class I
"1."(Level of Evidence: ) "
"2."(Level of Evidence: ) "
Class IIa
"1."(Level of Evidence: ) "
Class IIb
"1."(Level of Evidence:) "
"2."(Level of Evidence:) "



Common complications

Common complications
Pathogen Complications
Group A Streptococcus

Suppurative complications

Non suppurative complications

Influenza
Adenovirus
Cocksackie A virus
Ebstein barr virus
  • Airway obstruction
  • Splenic rupture
  • X-linked lymphoproliferative disease
  • Lymphomatoid granulomatosis
Less common complications
Gonococcus
Diphtheria
Heamophilis influenza
Fusobacterium necrophorum
Parainfluenza virus


Pathogen Complications
Diphtheria
  • A
  • B
  • C
  • D
Gonococcus
  • A
  • B
  • C
  • D
'
  • A
  • B
  • C
  • D
Cocksackie A virus
  • A
  • B
  • C
  • D
Ebstein barr virus
  • A
  • B
  • C
  • D
Gonococcus
  • B
  • C
  • D
HIV
  • B
  • C
  • D

MRI syphilis 17628376


Among women the median prevalence of genital warts was 1.1% (range 0.8 to 2.3) across all jurisdictions, compared to 4.0% (range 2.9 to 4.7) for MSM and 4.9% (range 3.3 to 5.5) for MSW.
Varicella containing vaccines Indications Efficacy and immunogenicity Recommended dose Duration
Varicella vaccine (Varivax)
  • Approved for persons 12 months and older
  • Detectable antibody
  • 97% of children 12 months through 12 years following 1 dose
  • 99% of persons 13 years and older after 2 doses
  • 70% to 90% effective against any varicella disease
  • 90%-100% effective against severe varicella disease
  • 2 doses separated by at least 4 weeks
Measles-mumps-rubella-varicella vaccine (ProQuad)
  • Approved for children 12 months through 12 years
  • Do not use for persons 13 years and older
  • Efficacy of MMRV vaccine was inferred from that of MMR vaccine and varicella vaccine on the basis of noninferior immunogenicity
  • Formal studies to evaluate the clinical efficacy of MMRV vaccine have not been performed[1]
  • May be used for both first and second doses of MMR and varicella vaccines
  • Minimum interval between doses is 3 months
Herpes zoster vaccine (Zostavax)
  • Approved for persons 50 years and older
  • Vaccine recipients 60 to 80 years of age had 51% fewer episodes of zoster
  • Efficacy declines with increasing age
  • Significantly reduces the risk of postherpetic neuralgia
  • Reduces the risk of zoster 69.8% in persons 50 through 59 years of age
  • Single dose at age 60 years or older (whether or not they report a prior episode of herpes zoster)
New Herpes zoster vaccine (Shingrix)
  • Adults aged 50 years or older (first pivotal phase 3 trial)
  • Adults aged 70 years and over (second pivotal phase 4 trial)
  • 89% (95% confidence interval: 69– 97) efficacious in preventing PHN in people aged 70 years
  • 91% (95% confidence interval: 76– 98) efficacious in people aged 50 years and over.
  • Two doses

| colspan="3" style="background: #4479BA; text-align: center;" | For individuals with penicillin allergy |- | style="padding: 5px 5px; background: #DCDCDC;" | Cephalexin, oral | style="padding: 5px 5px; background: #F5F5F5;" |

  • 20 mg/kg/dose twice daily (max = 500 mg/dose)

| style="padding: 5px 5px; background: #F5F5F5;" |

  • 10 days

|- | style="padding: 5px 5px; background: #DCDCDC;" | Cefadroxil, oral | style="padding: 5px 5px; background: #F5F5F5;" |

  • 30 mg/kg once daily (max = 1 g)

| style="padding: 5px 5px; background: #F5F5F5;" |

  • 10 days

|- | style="padding: 5px 5px; background: #DCDCDC;" | Clindamycin, oral | style="padding: 5px 5px; background: #F5F5F5;" |

  • 7 mg/kg/dose 3 times daily (max = 300 mg/dose)

| style="padding: 5px 5px; background: #F5F5F5;" |

  • 10 days

|- | style="padding: 5px 5px; background: #DCDCDC;" | Azithromycin, oral | style="padding: 5px 5px; background: #F5F5F5;" |

  • 12 mg/kg once daily (max = 500 mg)

| style="padding: 5px 5px; background: #F5F5F5;" |

  • 5 days

|- | style="padding: 5px 5px; background: #DCDCDC;" | Clarithromycin, oral | style="padding: 5px 5px; background: #F5F5F5;" |

  • 7.5 mg/kg/dose twice daily (max = 250 mg/dose)

| style="padding: 5px 5px; background: #F5F5F5;" |

  • 10 days

|- |}



Transmission Clinical Presentation Disease Diagnosis Mother to Child Transmission Most Serious Complications
Laboratory studies Clinical Diagnosis Vertical Transmission Trans-vaginal transmission
Primarily sexually transmitted Genital Dermatological Manifestation
(e.g., ulcers, chancre, vesicles, warts, balanitis etc.)
HPV Cervical Cancer
Herpes simplex-2 Severe pruritis/discomfort
Syphilis *Neurosyphilis
*Cardiosyphilis
Scabies Moderate to Severe pruritis/discomfort
Pubic lice Moderate to Severe pruritis/discomfort
Candidiasis
(in males)
Mild to moderate pruritis/discomfort
Generalized Symptoms
(e.g. constitutional symptoms
HIV *Primary CNS Lymphoma
*Immunosuppression (AIDS)
Syphilis *Neurosyphilis
*Cardiosyphilis
Urogenital infections
(e.g.,Vaginitis, Urethritis, Cervicitis, and PID)
Gonorrhea PID
Chlamydia PID
Syphilis *Neurosyphilis
*Cardiosyphilis
Mycoplasma genitalium unknown unknown PID
Trichomonas vaginalis PID
Less frequently sexually transmitted Generalized Symptoms
(e.g. constitutional symptoms)
Zika Virus Vertical transmission and Congenital abnormalities
Hepatitis B Hepatocellular Carcinoma
Hepatitis C Liver cirrhosis
Urogenital Infections
(e.g.,Vaginitis, Urethritis, Cervicitis, and PID)
Gardnerella vaginalis Moderate to severe discomfort
Candidiasis
(in females)
Moderate to severe pruritis/discomfort
Ureaplasma urealyticum Moderate to severe pruritis/discomfort

Postexposure prophylaxis

Active immunisation

Varicella vaccine is recommended for immunocompetent individuals exposed to varicella infection but did not receive full two dose course of vaccine previously[2][3]

Passive immunisation

VZV immunoglobulin

  1. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5903a1.htm Accessed on October 24, 2016
  2. Salzman MB, Garcia C (1998). "Postexposure varicella vaccination in siblings of children with active varicella". Pediatr Infect Dis J. 17 (3): 256–7. PMID 9535260.
  3. Asano Y, Nakayama H, Yazaki T, Kato R, Hirose S (1977). "Protection against varicella in family contacts by immediate inoculation with live varicella vaccine". Pediatrics. 59 (1): 3–7. PMID 190583.