Acute acquired infection in the immunecompetent patient

These infections are not treated unless significant organ dysfunction occurs (myocarditis, encephalitis) or unless systemic symptoms are severe or prolonged. When treatment is indicated, the combination of pyrimethamine and sulfonamides with folinic acid is recommended for a period of 3-4 weeks. Thereafter, a reassessment of the patient's condition should be performed. In severe cases, the usual daily dose of 25mg pyrimethamine may be increased to 50mg or more. In less-serious cases drugs of lower toxicity, such as spiramycin (3 g/day) or clindamycin (2 g/day), are recommended. Infection acquired by laboratory accidents or transfusion of blood products are potentially severe, and these patients should probably be treated regardless of signs or symptoms of infection (Haverkos 1987).

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