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Query: UMLS:C0004610 (bacteremia)
 13,199 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infantile transmural ulcerative enteritis is a disorder of early infancy characterized by feeding difficulties, intermittent and progressive diarrhea, cachexia, anemia, abdominal distention, and small-bowel dilation which may progress to intestinal obstruction. The pathologic process, of unknown etiology, involves a transmural enteritis with deep undermining mucosal ulceration, not unlike that seen in Crohn's disease, except that granulomas are usually not present. The early stages of the diseases may be reversible if the bowel is simply placed at rest by use of intravenous nutrition. In the later stages of the illness, there is progressive mechanical and functional intestinal obstruction due to inflammatory constriction of the distal small bowel and lack of effective peristalsis through the inflammed segments. The terminal stages are characterized by marked abdominal distention, complete obstruction, septicemia, and death. It is during the period of abdominal distention due to progressive intestinal obstruction that surgical intervention is of benefit. A cutaneous enterostomy proximal to the involved segments of small intestine serves to decompress the bowel, to minimize bacteremia, and to allow the distal inflamed intestine to heal. Total intravenous nutrition is mandatory for a period of several weeks until there is healing of the distal small bowel and closure of the enterostomy. In all surviving infants, bowel function has returned to normal and there have been no long-term sequelae or recurrences.
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PMID:Surgical management of infantile ulcerative enteritis. 80 75

A patient with recurrent intestinal obstruction and jejunocutaneous fistula was referred for treatment of the latter condition. Management with total parenteral nutrition was complicatied by bacteremia. Subsequently, a double-lumen tube was passed via an existing gastrostomy for purposes of aspirating above the level of the fistula and infusing appropriate nutrients and fluids distally. A period of marked clinical improvement was followed by increased fistula output and evidence of intestinal obstruction secondary to gaseous distention of a sealed latex terminal balloon which was retrieved only after percutaneous puncture. The unusual complication of prolonged intestinal intubation is discussed with special reference to this nonsurgical method of managing the impacted balloon and tube. Factors affecting balloon distention are discussed and the necessity of venting intestinal balloons reemphasized.
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PMID:Nonoperative retrieval of an impacted long intestinal tube. 85 56

This elderly male with a long history of alcohol abuse presented with an acute pleural trauma and hemopneumothorax, which may have served as the precipitating medical illness for cecal volvulus. He subsequently developed bacterial peritonitis as a complication of his bowel obstruction. It is probable that his pleural cavity was seeded hematogenously via a bacteremia from his peritonitis, thus accounting for the empyema with species typical of bowel flora. Cecal bascule is a type of cecal volvulus that causes intestinal obstruction. Diagnosis is difficult, but a delay in recognition may result in intestinal ischemia, perforation, sepsis, and even death. Cecal ischemia or gangrene cannot always be determined based on physical examination or laboratory findings. Plain films of the abdomen may be helpful, and barium enema has been advocated by some authors. However, laparotomy is often necessary for definitive diagnosis and therapy. While cecal volvulus has not been reported to occur frequently in the elderly, the relatively common occurrence of anatomic predisposition in addition to the widespread use of respirators and the increasing age and number of medical illnesses of our population make it possible that cecal volvulus will be seen with increasing frequency in the future.
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PMID:Cecal bascule: an overlooked diagnosis in the elderly. 172 51

Intussusception is a common cause of small bowel obstruction in infancy and early childhood. As in other forms of intestinal obstruction, there is stagnation of enteral content and edema of the bowel wall, theoretically facilitating translocation of bacteria. Since 1987, 85 cases of intussusception have been at this institution, of which 24 underwent laparotomy. Twenty (83%) developed a fever of more than 38.0 degrees at a mean of 11 hours postoperatively, lasting for less than 24 hours. Of the 61 cases that were treated by barium enema (a success rate of 72%), a similar fever peak was recorded in 26 (43%). All but who patients were afebrile on admission, and all were afebrile upon discharge. Hospital stay was 1.8 days for non-operated patients two remained afebrile and 2.9 days for those who developed a transient fever (p less than 0.05). We postulate that this temporary rise in temperature following manipulation of intussuscepted bowel is caused by a transient bacteremia or endotoxinemia due to bacterial translocation through the intestinal wall, similar to the process that has been described in other forms of intestinal obstruction. Awareness of this phenomenon could avoid needless fever workups, thereby reducing costs and hospital stay. The concept of bacterial translocation casts a doubt on the infectious theory of idiopathic intussusception, since the presence of infected mesenteric lymph nodes could follow, rather than proceed the intussusception.
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PMID:[Transient fever associated with a reduction of intestinal invagination]. 208 63

We designed a model of intestinal obstruction (IO) to study the histological alterations in the intestinal wall and the mesenteric lymph nodes (MLN). Therefore we used 32 Sprague-Dawley rats and under anesthesia a laparotomy was performed and the distal ileum was ligated with 3-0 silk, producing a complete occlusion. At different interval (24, 48, 72 and 96 hours) the animals were sacrificed by cervical dislocation and were histologically analyzed. At 24 hours post IO, congestion, edema and a inflammatory infiltrate were observed at the level of the lamina propia and the MLN were reactive. At 48 hours the congestion and edema increased and the intestinal mucosa began to fragment, allowing the bacteria to translocate and getting to the lymph nodes in the intestinal wall. The reactivity at the MLN increased. The observation of bacterial translocation in IO widen the scope of the alterations in this pathology, were not only absorption of toxic products and endotoxin occurs in the compromise segment and this phenomenon could explain the incidence of bacteremia and sepsis in the IO patients.
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PMID:[Factors involved in bacterial translocation in an experimental model of intestinal obstruction]. 253 59

Clinical and microbiologic data of 296 patients with anaerobic bacteremia were reviewed. Anaerobes were isolated with aerobic or facultative bacteremia in 23 instances. The Bacteroides fragilis group accounted for 148 (70%) of 212 isolates of Bacteroides species. B. fragilis accounted for 78% and B. thetaiotaomicron for 14%. Among other species, there were 20 (6%) Fusobacterium organisms, 63 (18%) Clostridium isolates, and 53 (15%) anaerobic cocci. Seventy-five patients died: 40 had B. fragilis group isolates - B. fragilis, 28, and B. thetaiotaomicron, 8 - and 21 had Clostridium organisms isolated. The primary portals of entry were the gastrointestinal tract (42%), decubiti and gangrene (10%), the female genital tract (8%), and the oropharynx (7%). The gastrointestinal tract, decubiti, and gangrene were the predominant sources for B. fragilis and Clostridium organisms, the female genital tract and oropharynx for anaerobic cocci and Fusobacterium species, and the oropharynx for pigmented Bacteroides. Foreign body was associated with Propionibacterium acnes and Clostridium species. Factors predisposing to bacteremia were abscesses, 53; malignancy, 51; surgery, 30; and intestinal obstruction or perforation, 27.
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PMID:Anaerobic bacterial bacteremia: 12-year experience in two military hospitals. 232 34

Abdominal infections are an important cause of morbidity and mortality in neutropenic patients. We present a retrospective series of 16 patients, mostly with acute leukemia, who developed severe abdominal infections during chemotherapy-induced neutropenia between 1991 and 1997. The frequency among patients with acute leukemia was 2.35% (13 of 553). Thirteen patients presented with enterocolitis and 3 patients presented with cholecystitis. Eight patients died. Bacteremia was present in 6 patients, 4 patients suffered from proven or strongly suspected fungal infections, and 1 patient suffered from cytomegalovirus infection. Early surgical management was required in a patient with intestinal obstruction, whereas other patients could be managed conservatively. Two patients with acute cholecystitis were treated with antibiotics until the end of neutropenia and then were resected. Severe abdominal injections in neutropenic patients, which are often fatal, were caused by nonbacterial microorganisms in one-fourth of the cases and could be managed conservatively in most instances.
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PMID:Severe abdominal infections in neutropenic patients. 1157 7

With the objective of determining the association between bacteremia and transoperative antegrade mechanical lavage of the colon in an experimental model of obstruction of the left colon in rats, 40 male Wistar rats aged between 90 and 120 days were divided randomly into four groups: A, with intestinal obstruction and with mechanical lavage of the colon; B, with intestinal obstruction and without mechanical lavage of the colon; C, without intestinal obstruction and with mechanical lavage of the colon; and D, without intestinal obstruction and without mechanical lavage of the colon. Analysis of the results showed that there was no bacteremia in the animals in the sham group. On the other hand, bacterial growth in blood cultures was found in three animals (30%) in group C and in four animals (40%) in group B. Positive blood culturing was presented by eight animals (80%) of the rats in group A, and variance analysis on this finding was statistically significant (p = .0029). It can be concluded that, in this experimental model, intestinal obstruction causes a fourfold increase in the risk of bacteremia, while lavage causes an almost threefold increase in the chance of bacterial dissemination into the blood stream. This explains why there was greater incidence of bacteremia in the animals with obstruction and with lavage.
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PMID:Analysis of bacteremia occurring in the presence of obstruction of the left colon in rats submitted to transoperative antegrade mechanical lavage. 1624 66

Four bacterial isolates were recovered from the blood cultures of four patients, two of whom were from Hong Kong and two of whom were from Canada. The two Hong Kong strains were isolated from a 48-year-old man with intestinal obstruction and secondary sepsis (strain HKU16T) and from a 39-year-old man with acute appendicitis (strain HKU17), while the two Canadian strains were isolated from a 74-year-old man with biliary sepsis (strain CA1) and from a 66-year-old woman with metastatic carcinoma and sepsis (strain CA2). While the first three patients survived, the last patient died 2 weeks after the episode of bacteremia. All four isolates are strictly anaerobic, nonsporulating, gram-positive coccobacilli that were unidentified by conventional phenotypic tests and commercial identification systems. They grow on sheep blood agar as nonhemolytic pinpoint colonies after 48 h of incubation at 37 degrees C in an anaerobic environment. All are catalase positive and motile, with flagella. They produce acid from arabinose, glucose, mannose, and xylose. They do not produce indole or reduce nitrate. They are sensitive to penicillin, vancomycin, and metronidazole but resistant to cefotaxime. 16S rRNA gene sequence analysis showed 16.0%, 16.8%, and 21.0% base differences from Clostridium propionicum, Clostridium neopropionicum, and Atopobium minutum, respectively. The G+C content of strain HKU16T is 40.2% +/- 2.2%. Based on their phylogenetic affiliation, unique G+C content, and phenotypic characteristics, we propose a new genus and species, Catabacter hongkongensis gen. nov., sp. nov., to describe the bacterium, for which HKU16 is the type strain, and suggest that it be assigned to a new family, Catabacteriaceae. The gastrointestinal tract was probably the source of the bacterium for at least three of the four patients. The isolation of a catalase-positive, motile, nonsporulating, anaerobic gram-positive bacillus in clinical laboratories should raise the possibility of C. hongkongensis. Further studies should be performed to ascertain the epidemiology and other disease associations of this bacterium.
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PMID:Catabacter hongkongensis gen. nov., sp. nov., isolated from blood cultures of patients from Hong Kong and Canada. 1712 22

Anaerobic bacteria remain an important cause of bloodstream infections and account for 1-17% of positive blood cultures. This review summarizes the epidemiology, microbiology, predisposing conditions, and treatment of anaerobic bacteremia (AB) in newborns, children, adults and in patients undergoing dental procedures. The majority of AB are due to Gram-negative bacilli, mostly Bacteroides fragilis group. The other species causing AB include Peptostreptococcus, Clostridium spp., and Fusobacterium spp. Many of these infections are polymicrobial. AB in newborns is associated with prolonged labor, premature rupture of membranes, maternal amnionitis, prematurity, fetal distress, and respiratory difficulty. The predisposing conditions in children include: chronic debilitating disorders such as malignant neoplasm, hematologic abnormalities, immunodeficiencies, chronic renal insufficiency, or decubitus ulcers and carried a poor prognosis. Predisposing factors to AB in adults include malignant neoplasms, hematologic disorders, transplantation of organs, recent gastrointestinal or obstetric gynecologic surgery, intestinal obstruction, diabetes mellitus, post-splenectomy, use of cytotoxic agents or corticosteroids, and an undrained abscess. Early recognition and appropriate treatment of these infections are of great clinical importance.
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PMID:The role of anaerobic bacteria in bacteremia. 2002 84


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