Primary Nonresponders

Occasionally, diarrhea may persist (or recur) despite some weeks of treatment. We have found that this is suggestive of an associated infection with Giardia lamblia, rather than necessarily being refractory (or relapsing) WD. Associated G. lamblia may easily escape notice in PAS stained biopsies. This protozoan requires other drugs to become eradicated.

Rarely, a patient with intestinal WD does not respond to adequate primary treatment (see above) and does not reach clinical and mucosal remission after 1 year. In our personal series, there are 2 nonresponders among 162 patients (Von Herbay et al, 1996). Salvage therapy should be planed on an individual basis.

As mentioned, the real challenge of treatment is to eradicate asymptomatic CNS infection. In those patients who do not respond to initial treatment with ceftriaxone, a second course with meropeneme should follow. Further salvage therapy should be planned on an individual basis.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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