Internal Medicine

0521779407-19 CUNY1086/Karliner 0 521 77940 7 June 6, 2007 17:50

1370 Sporotrichosis Staphylococcal Infections

Side Effects & Complications

■Potassium Iodide (SSKI)

■Side effects: bitter taste, nausea, anorexia, diarrhea, rash, parotid

gland enlargement

■Itraconazole

➣Side effects: nausea, vomiting, anorexia, abdominal pain, rash;

rarely hypokalemia and hepatitis

➣Contraindications: end-stage renal disease for cyclodextran

solution; lower cyclosporin dose when concomitantly given; may

dangerously increase serum levels of digoxin, astemizole and

loratadine, causing fatal arrhythmias

■Amphotericin B

➣Side effects: fevers, chills, nausea, vomiting and headaches; rig-

ors may be prevented by the addition of hydrocortisone 25 mg to

bag, meperidine 25–50 mg may treat rigors; nephrotoxicity; elec-

trolyte disturbance (renal tubular acidosis, hypokalemia, hypo-

magnesemia)

■Contraindications: if Cr 2.5–3.0, may consider giving lipid-based

Amphotericin products

follow-up

■For cutaneous disease: assess resolution of nodules

■Treat for as long as needed, may require several months

complications and prognosis

Complications

■Functional impairment with bone and joint destruction in osteoar-

ticular disease

Prognosis

■For cutaneous/localized disease: excellent prognosis

■For disseminated disease: poor prognosis, may be fatal

STAPHYLOCOCCAL INFECTIONS

RICHARD A. JACOBS, MD, PhD

history & physical

History

■Clinically relevant species:Staphylococcus aureus,Staphylococcus

epidermidisand other coagulase-negative staphylococci