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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Staphylococcus aureus produces many extracellular products often referred to as toxins, some with definite disease-causing potential. The enterotoxins A through E are common causes of acute food poisoning characterized by a short incubation period after ingestion of performed toxin followed by nausea, vomiting, abdominal pain, and diarrhea. The epidermolytic toxins (A, B) are absorbed from a local site of colonization or infection and affect the granular cell layer of skin to cause the painful erythroderma and desquamation of the scalded skin syndrome. Other unique S. aureus strains produce one or more products that appear to be formed at sites of focal infection (wound infection, vagina during menstruation and tampon use) with systemic absorption and generalized effects resulting in toxic shock syndrome.
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PMID:Staphylococcal toxin syndromes. 315 68

We report the case of a 15-year-old girl who developed high fever, syncope, abdominal pain, nausea and vomiting, myalgia, pharyngitis, and a desquamating rash eight days after a diagnostic peritoneal lavage. The diagnostic peritoneal lavage wound was erythematous and tender. Incision of the site yielded 10 mL of exudate that cultured Staphylococcus aureus. The patient was treated with a first-generation cephalosporin and recovered without sequelae. To our knowledge, this is the first reported case of toxic shock syndrome following diagnostic peritoneal lavage.
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PMID:Toxic shock syndrome following diagnostic peritoneal lavage. 328 25

A 14-year-old girl was hospitalized with fever, jaundice, vomiting and right sided abdominal pain. A laparotomy was performed because of muscular defence and ascites. There was a mass of enlarged red and blue colored lymph nodes in the mesentery of the lower ileum loop. The histologic diagnosis of HNL without granulocytic infiltration was made. A septic-toxic shock developed after surgery. Respiratory insufficiency necessitated the use of a respirator, and acute renal failure with oliguria made hemodialysis necessary. The dramatic clinical course of the illness and the localization of the affected lymph nodes in the abdomen are unusual for an HNL; the lack of granulocytic infiltration contradicts the clinical picture of a bacterial infection. Neither a bacterial nor a viral pathogen could be found. However, the patient had been treated with antibiotics before.
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PMID:Mesenterial histiocytic necrotizing lymphadenitis. Case report. 366 31

The following conclusions were drawn from a study of 15 cases of pseudo-membranous coloproctitis (PMCP): PMCP was seen in subjects of both sexes and all ages. The causative agent was found in all antibiotic classes. Clinical signs comprised constant diarrhea, fever, abdominal pain, toxic shock and, more rarely, pseudo-occlusive, pseudo-perforative surgical evidence. Diagnosis involved visualization of pseudo-membranes by endoscopy. Lesions were most frequent in the left colon and increased in severity towards the distal end. Three stages were distinguished by histological examination: superficial necrosis of the mucous membranes, interruption of glands, complete necrosis of the mucous membrane. Without preparation the abdomen did not provide specific information; nor did barium enema which revealed lesions that were frequently diffuse but more marked in the left colon. Conventional coprocultures did not provide diagnostic information. Only a more sophisticated technique will be capable of detecting the pathogen currently considered to be the cause of PMCP: Clostridium difficile. The course of the disorder is generally satisfactory under medical treatment (parenteral feeding, vancomycin) but may sometimes call for surgery.
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PMID:[Pseudomembranous rectocolitis]. 375 11

Three patients were recently treated for thrombotic thrombocytopenic purpura (TTP). One presented with toxic shock syndrome; TTP developed but promptly responded to a regimen of antiplatelet agents, steroids and plasma exchange. In another the manifestations of TTP developed after presentation with hypertension and abdominal pain. This patient responded to a similar regimen but required extended treatment before remission could be maintained with medications alone. In the third patient the full TTP syndrome appeared after several days of plasma exchange treatment for hemolyticuremic syndrome. He did not respond. It is suggested that TTP may present in many forms initially, that microangiopathic hemolysis may be a late manifestation and that the optimal therapy is not known.
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PMID:Plasma exchange in thrombotic thrombocytopenic purpura. 654 65

Three menstruating adolescents using tampons colonized with Staphylococcus aureus developed high fever, vomiting, diarrhea, and abdominal pain followed by conjunctival injection and a sunburn-like rash. Two girls had transient orthostatic hypotension but none developed shock or evidence of multiple organ injury. They are reported as having probably toxic shock syndrome without shock or multiple organ system involvement.
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PMID:Probable toxic shock syndrome without shock and multisystem involvement. 709 96

In Pennsylvania, a 29-year-old woman was admitted to Temple University Health Sciences Center in Philadelphia with hypotension (100/80 mmHg), fever (105.3 degrees Fahrenheit), and a diffuse, nondesquamating erythroderma. Five weeks earlier, she had delivered her last child vaginally. Three days before admission, she had undergone endotracheal intubation so surgeons could perform a laparoscopic tubal ligation with Falope Rings. Two days before the tubal ligation, she had had a sore throat. She experienced no surgical complications and was discharged the same day as the operation. The day before her latest admission, she experienced nausea, vomiting, diarrhea, fever, chills, and diffuse abdominal pain. Upon admission, her surgical incisions were clean and dry and had no erythema. Her pulse rate was 140 beats/minute. Her respiration rate was 20/minute. The white blood cell count was 15,200 cells/cu. m (71% neutrophils, 23% band forms, 2% lymphocytes, and 4% monocytes). Her potassium level was 3.2 mmol/l. The anion gap was 22. All blood and urine cultures were negative. She experienced mild uterine tenderness. Upon admission, physicians administered ticarcillin-clavulanate and vancomycin for suspected postoperative pelvic infection. After learning that cervical and pharyngeal cultures were positive for Streptococcus pyogenes, physicians changed to ampicillin, 1 g intravenously every 6 hours. On the 6th day, she was discharged and prescribed 500 mg oral amoxicillin every 8 hours for 2 weeks. Within 2 weeks, she felt fine, had a normal physical examination, no fever, and no rash. The major signs and symptoms indicated a toxin-mediated illness. Both mucosal surfaces colonized by S. pyogenes were manipulated during laparoscopy and manipulation may have caused minor tissue injury and hyperemia with subsequent dissemination of streptococcal toxin. In conclusion, the patient had a S. pyogenes toxin-induced toxic shock-like syndrome that mimicked a pelvic wound infection with gram-negative septicemia.
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PMID:Streptococcal toxic shock-like syndrome as an unusual complication of laparoscopic tubal ligation. A case report. 799 32

Toxic shock syndrome (TSS) is classically associated with vaginal recovery of Staphylococcus aureus during menses. In this case a patient presented with fever, rash, abdominal pain and signs of shock, 6 days postpartum. Blood cultures were negative but endometrial cultures were positive for Group A beta-hemolytic streptococcus. This case presents a toxic shock-like syndrome due to streptococcus, (toxic streptococcus syndrome) and points out the importance of culturing these patients for organisms other than Staphylococcus aureus.
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PMID:A severe puerperal group A streptococcal infection causing a toxic shock-like syndrome. 809 77

A thirty-three year old female presented to our emergency department complaining of severe abdominal pain, nausea, and vomiting. On physical examination she was hypotensive with a firm, tender abdomen, cervical motion tenderness and a diffuse erythematous rash. A surgical diagnosis of Acute Pelvic Inflammatory Disease was made during laparoscopy. Coagulant studies, liver function tests, culture results, and the desquamation of the patient's palms led to the additional diagnosis of Toxic Shock Syndrome. A literature search failed to reveal any similar cases of Pelvic Inflammatory Disease (PID) and Toxic Shock Syndrome (TSS) occurring concomitantly. Patients may present severely ill with either of these disease entities but potential for serious illness is greater when both of these syndromes occur in the same patient. We conclude that in patients with a similar presentation, the symptoms should not be attributed completely to PID without further investigation and consideration of a concomitant disease process including TSS.
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PMID:A 33-year-old white female with abdominal pain, nausea, vomiting and hypotension. 834 May 81

A 14-year-old girl presented with symptoms resembling acute appendicitis. Five days after appendectomy and continued fever and severe abdominal pain, blood cultures were found positive for Streptococcus pyogenes. Two days later a diagnosis of group A streptococcal peritonitis with necrotizing retroperitoneal fasciitis was confirmed by retroperitoneal cultures obtained at laparotomy. Although multiple organ systems showed impaired functioning, including hepatic, renal and respiratory changes, she did not meet the criteria for streptococcal toxic shock syndrome. She was treated with a combination of high-dose parenteral penicillin and clindamycin, followed by prolonged treatment with clindamycin orally. Recovery was complicated by persistent hydronephrosis, which was slow to resolve.
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PMID:Necrotizing fasciitis of the retroperitoneum: an unusual presentation of group A Streptococcus infection. 957


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