Internal Medicine

0521779407-10 CUNY1086/Karliner 0 521 77940 7 June 6, 2007 17:44

878 Isosporiasis Jaw Swelling and Masses

Treatment Options

■Trimethoprim-sulfamethoxazole

■Pyrimethamine alone in case of sulfa allergy

Side Effects & Complications

■Usually due to sulfamethoxazole: rash, fever, leukopenia, thrombo-

cytopenia

■Contraindications to treatment: absolute: allergy to medications

■Contraindications to treatment: relative: asymptomatic patient

follow-up

During Treatment

■Watch for allergic reactions.

Routine

■Follow-up stool exam 2–3 weeks after treatment finished

complications and prognosis

■Prognosis is good in immunocompetent host. Immunocompro-

mised patients may need chronic therapy.

JawSwelling and Masses...............................

ANDREW H. MURR, MD, FACS

history & physical

History

■Duration

■Changes in size

■Presence or absence of pain

■Exposure to animals or pets

■Recent travel

■Accompanying cold or upper respiratory infection

■Recent dental work or toothache

■History of immunocompromise

■Fatigue, night sweats, lethargy

■History of chronic cough

■History of cigarette smoking and alcohol use

■Asian ancestry (for nasopharyngeal carcinoma)

Signs & Symptoms

■Size and shape, presence or absence of tenderness or erythema,

mobility versus fixation, fluctuance, skin necrosis.