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   Oct 12

DONOVANOSIS (GRANULOMA INGUINALE) – CLINICAL MANIFESTATIONS

The incubation period is usually from one to four weeks but can be much longer. The disease begins as single or multiple subcutaneous nodules usually on the genitalia, which erode through the skin to produce painless ulcers or exuberant granulations. Anorectal lesions may occur in homosexual mea Secondary infection may contribute to necrotic debris on [...]

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   Oct 12

DONOVANOSIS (GRANULOMA INGUINALE) – DEFINITION AND DIAGNOSIS

Donovanosis is a mildly contagious, chronic progressively destructive infection caused by Calymmatobacterium granulomatis, a gram-negative, oval bacillus in which polar bodies are often prominent. The organism develops intracellularly and is difficult to culture. This disease occurs in tropical countries including Papua New Guinea and, although uncommon in Australia, appears to be endemic in Aboriginal people [...]

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   Oct 12

SYPHILIS – FOLLOW-UP AFTER TREATMENT

The patient with early syphilis should return for repeat examination and serology at the following intervals: at one month; at regular 3 monthly intervals for 1 year, and at 6 monthly intervals for the second year. Patients with late syphilis should be followed indefinitely; patients with neurosyphilis should have periodic CSF examinations for at least [...]

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   Oct 12

SYPHILIS – JARISCH-HERXHEIMER REACTION; RETREATMENT

This reaction is a consequence of treponemal destruction. It occurs 6 to 12 hours after commencing treatment and is a mild reaction with fever, headache, malaise, rigors and joint pain. The reaction lasts for several hours and does not recur. Symptoms are controlled by paracetamol and rest. Retreatment Only one course of treatment is normally [...]

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   Oct 12

SYPHILIS – PENICILLIN SENSITIVE PATIENTS

For any patient with syphilis who can not be treated with penicillin, specialist advice should be sought. A tetracycline such as doxycycline is the second line drag of choice. Erythromycin is less reliable and is rarely indicated. Recommended regimens for these drugs are: Early syphilis Doxycycline 300 mg daily orally in single or divided doses [...]

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   Oct 12

SYPHILIS – ANTIBIOTIC TREATMENT 3

Antenatal screening and control of early infectious syphilis are essential for the control of congenital syphilis. Seropositive women must be evaluated and treated promptly. Regardless of the stage of pregnancy, patients who are not allergic to penicillin should be treated with penicillin according the regimens above. Pregnant patients with confirmed penicillin sensitivity should be referred [...]

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