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PRINCIPLES OF INTERNAL MEDICINE - PART 4

nhiễm trùng bị thay đổi, thông tin chính xác vẫn còn cung cấp cho hầu hết các bệnh nhân nhiễm HIV. Cao hơn đáng kể trong huyết thanh nồng antitreponemal đã được báo cáo ở những bệnh nhân nhiễm HIV so với những người không bị nhiễm virus. | 114 VI. Infectious Diseases Answers infection is altered accurate information is still provided for most patients with HIV infection. Significantly higher serum antitreponemal titers have been reported in patients with HIV compared with those not infected with the virus. Patients with documented secondary syphilis may fail to exhibit positive serology. False-positive serologic studies are also possible in HIV-infected patients who may exhibit polyclonal B cell activation early in the course of their infection. It has been shown consistently that single-dose penicillin therapy for early syphilis is more prone to failure in HIV-infected patients than in those who are not infected with the virus. It is particularly troubling that the central nervous system may be a sanctuary from penicillin. VI-68. The answer is D. Chap. 309. Cardo et al N Engl J Med 337 1485-1490 1997. The risk of HIV infection in a health care worker exposed to the blood of an HIV-infected patient by a needle stick exposure is small but real. The risk approximately 3 in 1000 such exposures could be decreased further if workers could adhere to the standard guidelines for dealing with sharp objects. Risk of transmission of hepatitis B from patient to worker in a similar situation is much higher there are cases of health care workers exposed to the blood of patients infected with both HIV and hepatitis B who contracted only hepatitis B. However in the face of a known parenteral exposure to HIV postexposure prophylaxis is recommended a combination of two nucleoside analogue reverse transcriptase inhibitors given for 4 weeks or a combination of two nucleoside analogue reverse transcriptase inhibitors plus a protease inhibitor given for 4 weeks . Most clinicians choose the second regimen. VI-69. The answer is D. Chap. 200 Successful treatment of antifungal infections is not as straightforward as that for bacterial infections. The topical imidazoles that are available for the treatment of vaginal .