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苄星青霉素G短缺与二期梅毒

Benzathine Penicillin G Shortage and Secondary Syphilis.

作者信息

Snider William, Depew Ian, Cook Shane, Roth Danielle

机构信息

Dermatology, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.

出版信息

Cureus. 2024 Aug 13;16(8):e66787. doi: 10.7759/cureus.66787. eCollection 2024 Aug.

Abstract

Syphilis is a sexually transmitted infection caused by the bacterium . This disease is characterized by four different stages, each presenting with a variety of manifestations or asymptomatic disease. These stages can be further broken down into early-stage syphilis, which includes primary and secondary syphilis, and late-stage syphilis, which includes tertiary syphilis. It is crucial to recognize and treat syphilis early because the later stages of the disease are marked by irreversible damage to the central nervous system (CNS) and cardiovascular system, and can even increase mortality risk. The primary recommended treatment for early-stage syphilis is intramuscular (IM) benzathine penicillin G (BPG). In this case report, we present a patient with secondary syphilis who exhibited red papules and nonspecific skin eruptions. Due to the unavailability of BPG, the patient initially received doxycycline as an alternative treatment. After eight days of searching multiple facilities and pharmacies, a dose of BPG was finally located and administered to the patient. We highlight crucial information about the BPG shortage, including supply and demand challenges, infrastructure issues, and the broader impact on numerous other antimicrobials. We emphasize the importance of recognizing this issue and provide alternatives for managing the disease in resource-limited settings.

摘要

梅毒是一种由细菌引起的性传播感染。这种疾病具有四个不同阶段,每个阶段都有多种表现形式或无症状疾病。这些阶段可进一步细分为早期梅毒,包括一期和二期梅毒,以及晚期梅毒,包括三期梅毒。早期识别和治疗梅毒至关重要,因为疾病的后期会对中枢神经系统(CNS)和心血管系统造成不可逆转的损害,甚至会增加死亡风险。早期梅毒的主要推荐治疗方法是肌内注射苄星青霉素G(BPG)。在本病例报告中,我们介绍了一名患有二期梅毒的患者,其表现为红色丘疹和非特异性皮疹。由于无法获得BPG,该患者最初接受多西环素作为替代治疗。在对多个医疗机构和药店进行八天的搜寻后,终于找到了一剂BPG并给患者使用。我们强调了有关BPG短缺的关键信息,包括供需挑战、基础设施问题以及对许多其他抗菌药物的更广泛影响。我们强调认识到这个问题的重要性,并提供在资源有限环境中管理该疾病的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c64/11392051/7814592c451f/cureus-0016-00000066787-i01.jpg

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本文引用的文献

1
Repurposing antibiotics to treat syphilis.
Lancet Infect Dis. 2024 Apr;24(4):335-336. doi: 10.1016/S1473-3099(23)00693-X. Epub 2024 Jan 8.
4
Resurgence of Syphilis in the United States: An Assessment of Contributing Factors.美国梅毒的再度流行:促成因素评估
Infect Dis (Auckl). 2019 Oct 16;12:1178633719883282. doi: 10.1177/1178633719883282. eCollection 2019.
7
Treatment of syphilis: a systematic review.梅毒的治疗:一项系统评价。
JAMA. 2014 Nov 12;312(18):1905-17. doi: 10.1001/jama.2014.13259.

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