Infection recovery

Antiviral therapy has no proven benefit in alphavirus infections. Recovery... 

Clinically, GM-CSF or G-CSF have been used to accelerate recovery after chemotherapy and total body or extended field irradiation, situations that cause neutropenia and decreased platelets, and possibly lead to fatal septic infection or diffuse hemorrhage, respectively. G-CSF and GM-CSF reproducibly decrease the period of granulocytopenia, the number of infectious episodes, and the length of hospitalization in such patients (152), although it is not clear that dose escalation of the cytotoxic agent and increased cure rate can be rehably achieved. One aspect of the effects of G-CSF and GM-CSF is that these agents can activate mature cells to function more efficiently. This may, however, also lead to the production of cytokines, such as TNF- a, that have some toxic side effects. In general, both cytokines are reasonably well tolerated. The side effect profile of G-CSF is more favorable than that of GM-CSF. Medullary bone pain is the only common toxicity. 

Drug 6-1574 has been demonstrated to ensure a 100% recovery of spontaneously Hymenolepis nana-infected albino mice given doses 2.5-5 times lower than the ED of phenasal (niclosamide) (94MI1). 

Varizella zoster vitus (VZV) is a highly contagious herpesvirus causing chickenpox upon primary infection. After recovery, the vims stays dormant in nerve roots. Weakening of the immune system, e.g. in people over the age of 60 or under immunosuppressive therapy, can lead to reactivation of VZV. This recurrence causes shingles (herpes zoster), a painful rash that develops in a well-defined band corresponding to the area enervated by the affected nerve cells. 

M ore than 200 viruses have been identified as capable of producing disease Acute viruses, such as the common cold, have a rapid onset and quick recovery. Chronic viral infections, such as acquired immunodeficiency syndrome (AIDS), have recurrent episodes of exacerbations (increases in severity of symptoms of the disease) and remissions (periods of partial or complete disappearance of the signs and symptoms). Display 14-1 describes the viruses discussed in this chapter. 

Herpes zoster (shingles) is caused by the varicella (chickenpox) virus. It is highly contagious. The virus causes chickenpox in the child and is easily spread via the respiratory system. Recovery from childhood chickenpox results in the infection lying dormant in the nerve cells. The virus may become reactivated later in life as the older adult s immune system... 

Ison MG, Gubareva LV, Atmar RL, Treanor J, Hayden EG (2006a) Recovery of drug-resistant influenza virus from immunocompromised patients a case series, J Infect Dis 193 760-764 Ison MG, Mishin VP, Braciale TJ, Hayden EG, Gubareva LV (2006b) Comparative activities of oseltamivir and A-322278 in immunocompetent and immunocompromised murine models of influenza virus infection, J Infect Dis 193 765-772... 

Particular strains of salmonellae (section 4.2) such as Sal. typhi, Sal. paratyphi and Sal. typhimurium are able not only to penetrate into intestinal epithelial cells and produce exotoxins but also to penetrate beyond into subepithelial tissues. These organisms therefore produce, in addition to the usual symptoms of salmonellosis, a characteristic systemic disease (typhoid and enteric fever). Following recovery frxm such infection the organism is commonly found associated with the gall bladder, hi this state, the recovered person will excrete the organism and form a reservoir for the infection of others. 

Treat acute bacterial conjunctivitis with broad-spectrum antibiotics. Although the condition is usually self-limiting, antibiotic treatment decreases the spread of disease to other people and prevents extraocular infection. Additionally, treatment may help decrease the risk of corneal ulceration or other complications that affect sight. Finally, treatment speeds recovery.14... 

Consider how to minimize the patient s risk of contracting the current (and other) CNS infections in the future administer appropriate vaccines after recovery from the acute infection. 

Therapeutic response should be based on clinical signs and symptoms. A repeat toxin assay as a test of cure is not recommended because some patients may remain colonized with this organism following recovery. Treatment of asymptomatic colonized patients is not recommended as an infection-control measurement. 

An additional important component of therapy is nutrition. Intraabdominal infections often involve the GI tract directly or disrupt its function (paralytic ileus). The return of GI motility may take days, weeks, and occasionally, months. In the interim, enteral or parenteral nutrition as indicated facilitates improved immune function and wound healing to ensure recovery. 

Some forms of invasive candidiasis are dominated by deep organ infection and may never be detected by blood cultures. Chronic disseminated candidiasis or hepatosplenic candidiasis is a unique form of candidemia seen after recovery from neutropenia. Candidemia during the period of neutropenia may be initially localized to the portal circulation with dissemination to contiguous organs. After recovery of neutrophils, an inflammatory response is seen against areas of focal infection in the liver and spleen. This inflammatory response produces abdominal pain that is associated with... 

Close monitoring of HCT recipients for infections is necessary because recovery of immune function is slow, sometimes requiring over 2 years, even in the absence of immunosupressants.104 Fevers should be assessed and treated rapidly to minimize the likelihood of a fatal infection. HCT recipients—both autologous and allogeneic—lose protective antibodies to vaccine-preventable diseases the CDC and the European Group for Bone Marrow Transplantation have issued recommendations for reimmunization for HCT recipients.107... 

Counsel the patient regarding adherence to prophylactic antibiotic, antifungal, and antiviral regimens. Evaluate the patient for infection and adverse drug reactions to antibiotics, antifungals, and antivirals. Ensure that the patient is appropriately immunized after recovery from HCT. 

The CSFs should not be used routinely for treatment of febrile neutropenia in conjunction with antimicrobial therapy.5 However, the use of CSFs in certain high-risk patients with hypotension, documented fungal infection, pneumonia, or sepsis is reasonable. A recent meta-analysis demonstrated that hospitalization and neutrophil recovery are shortened and that infection-related mortality is marginally improved.14 As with prophylactic use of these agents, cost considerations limit their use to high-risk patients. 

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