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

This article provides a framework for the hematologic evaluation of the urology patient. The discussion is based on an analysis of test results obtained from routine screening laboratory studies as the complete blood count and platelet count. The use of automated blood counts also provides quantitative indices of red cell morphology which facilitate the diagnosis of red blood cell disorders. To aid in categorizing hematologic disorders, abnormalities of the red blood cells, white blood cells, and platelets are discussed separately. In some circumstances where a disease process, such as bacteremia, alters more than one of the formed elements of the blood, this speparate analysis approach is less appropriate. Nevertheless, this division is generally useful in arriving at the correct interpretation of hematologic abnormalities. Within each category of abnormal test results, a variety of etiologies is listed. Elaboration is reserved for the entities commonly seen in hospitalized patients. For a more detailed discussion of the common disorders or for a more inclusive listing of the less common disorders, the bibliography lists a selection of useful references.
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PMID:The hematologic evaluation of the urologic patient. 96 Mar 10

Listeria monocytogenes is a Gram-positive bacillus that is pathogenic in both the normal and compromised host. We describe Listeria peritonitis and cerebritis in a patient with cirrhosis due to non-A, non-B hepatitis, and review the 11 other cases of Listeria peritonitis reported in the English-language literature. Listeria is a rare cause of peritonitis in debilitated, older patients, with two-thirds of the cases occurring in patients with chronic liver disease. Listeria peritonitis may also occur in patients undergoing peritoneal dialysis, or in those with malignancy. Peritonitis due to Listeria is clinically similar to spontaneous bacterial peritonitis, and is associated with fever, variable abdominal pain, and neutrocytic ascites; bacteremia commonly accompanies Listeria peritonitis. This syndrome can be successfully treated with antimicrobial drugs, although the third-generation cephalosporins commonly used in the therapy of spontaneous bacterial peritonitis are not recommended. Ampicillin may be the drug of choice, with combination therapy with an aminoglycoside reserved for cases that do not respond to ampicillin alone.
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PMID:Listeria monocytogenes peritonitis: case report and literature review. 144 54

Although rare, tropical pyomyositis can result from staphylococcal bacteremia and should be considered in the different diagnosis of fever associated with extremity pain. The diagnosis is readily made with a CT scan. Treatment is primarily medical with surgery reserved for refractory abscesses.
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PMID:Tropical pyomyositis. 155 7

An epidemiological survey was carried out which included a dual epidemic of septicaemia and pseudo-bacteremia caused by Serratia marcescens. The survey enabled 15 septicaemias and 43 pseudobacteremias to be detected in a regional hospital between March and August, 1983. Two mishandlings were at the origin of the outbreak: citrated tube normally reserved for coagulation tests were severely contaminated by Serratia marcescens, and inaccurate samplings had been made. Once the mechanisms of contamination were found, specific preventive measures put an end to the epidemic. The authors insist on the need for uncontaminated tubes and citrate solutions and for the development of precise sampling methods which are essential to avoid the occurrence of pseudo-bacteremia or septicaemia. It is important to detect such epidemics at an early stage by an efficient control of nosocomial infections, thus avoiding their extension.
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PMID:[Nosocomial septicemia and pseudobacteremia caused by Serratia marcescens]. 297 35

Central venous catheter-related infection and evidence for central venous thrombosis developed in five patients. On the basis of ongoing bacteremia after catheter removal and venographic confirmation, catheter-related septic central venous thrombosis (CR-SCVT) was confirmed. These patients were treated successfully with anticoagulation and antibiotics; none required surgical exploration or drainage.CR-SCVT is a complication of modern venous access techniques and is easily confused with sepsis from other anatomic sites. Even when recognized antemortem, CR-SCVT carries an excessive morbidity and mortality. The therapy for this complication is not standardized, but catheter removal, anticoagulation and a prolonged course of antibiotics are appropriate initial therapy. Surgical vein ligation or excision are reserved for refractory sepsis or abscess formation.
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PMID:Catheter-related septic central venous thrombosis--current therapeutic options. 376 99

The authors test the effectiveness of ornidazole in digestive surgery and surgical reanimation. They emphasize the increased frequency of anaerobic bacteria and the role of beta-lactamine and aminoside antibiotics in the selection of these pathogens. Ornidazole was used for a one year period as either a curative or prophylactic treatment. The product is very well tolerated. During the year the authors noted a decreased frequency of bacteroides bacteremia. They highly recommend the association of penicillin G in traumatology to fight gram negative anaerobic bacilli and numerous gram positive bacteria. The association with gentamycin is justified in the presence of an anaerobic gram negative digestive flora. The use of third generation antibiotics has often proved to be futile. It is recommended that they be reserved for the most resistant organisms seen in primary extra-hospital infections. The prescription of ornidazole must procede and follow the surgical eradication of focal intra-abdominal infections, especially if it is an infection of appendicular origine.
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PMID:[Ornidazole in digestive surgery and surgical intensive care (author's transl)]. 711 21

We prospectively evaluated the use of peripherally inserted central venous catheters to provide ongoing venous access in general medical and surgical patients in a Department of Veterans Affairs medical center. Between 1985 and 1988 trained nurses successfully inserted 393 catheters in 460 suitable patients (an 85.4% success rate). Correct catheter tip placement in the superior vena cava was documented in 359 of the 393 (91.3%) catheter insertions, but an additional 30 catheters were in a position deemed adequate for the intended use. The mean duration of catheter use was 27.6 +/- 5.2 (1 standard deviation) days (median 20 days, range 1 to 370 days). A total of 65 patients left the hospital with catheters in place, with the mean length of catheter use at home being 36.2 +/- 6.0 days (range 2 to 266). In all, 79% of the catheters were in use until the successful completion of therapy or patient death; catheter-related complications led to premature catheter removal in the remaining 21%. Catheter-related complications included bland phlebitis (8.2%), occlusion (8.2%), local infection (3.6%), bacteremia or fungemia (2.1%), mechanical failure or rupture (2.6%), venous thrombosis (0.7%), and other (3.3%). One patient required vein excision for the management of suppurative phlebitis, but no deaths were attributed to catheter use. This study illustrates the use and safety of peripherally inserted central venous catheters to provide reliable vascular access over prolonged periods in an elderly veteran population. At our facility, percutaneous central venous catheters and surgically implanted (Hickman or Broviac) catheters are now reserved for use in patients in whom peripherally inserted catheters cannot be placed.
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PMID:Peripherally inserted central venous catheters. Low-risk alternatives for ongoing venous access. 812 98

The clinical and laboratory issues important in pediatric blood cultures are similar to those in adult blood cultures with a few noteworthy exceptions. The collection of an uncontaminated specimen and an ample volume of blood is more difficult, especially in neonates. In addition, children often have previously received oral antibiotics or a broad-spectrum parenteral antibiotic. The relative frequencies of the pathogens causing bacteremia in children are different in important ways from in adults. Haemophilus influenzae b, although much less common than in the past, is still an important pediatric pathogen. Meningococcemia is relatively more common in children than in adults, and enterobacteriaceae and anaerobes are relatively less common. Group B streptococci, E. coli, coagulase-negative staphylococci, and Candida sp. are the principal pathogens in neonates. More changes in the distribution of blood-borne pathogens can be expected in the future with the introduction of new or more effective vaccines against the pneumococcus, meningococcus, and, possibly, group B streptococcus. In suspected community-acquired bacteremia in otherwise normal children, a single aerobic blood culture of adequate volume is sufficient. Sick neonates, hospitalized children with indwelling intravascular devices, and immunocompromised children may need multiple blood cultures, paired cultures from an indwelling vascular catheter and a peripheral vein, or use of special media. There is no single optimal system for pediatric blood cultures. The BACTEC systems have been adopted as a single system in many hospitals serving both children and adults because of the favorable results reported in children and the preference of using a single automated system. To maximize the detection of bacteremia and fungemia, some laboratories may wish to combine a BACTEC system with a second complementary system, such as the Isolator. Anaerobic, mycobacterial, and other special blood culture media should be reserved for selected patients.
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PMID:Pediatric blood cultures. 818 Dec 29

Bartonella (Rochalimaea) henselae is a common cause of cat-scratch disease. This newly identified bacterium is also the cause of several other clinical syndromes, including bacillary angiomatosis, bacillary peliosis hepatitis and splenitis, and acute and relapsing bacteremia. A high percentage of young cats carry B. henselae. Fortunately, serious complications of B. henselae infections are rare in immunocompetent patients. Cat-scratch disease is usually a self-limited illness that does not necessarily require antibiotic therapy. Severe or persistent cases respond well to several antibiotics, including erythromycin and doxycycline. Cat-scratch disease should be included in the differential diagnosis of serious neurologic disease, particularly when regional lymphadenopathy develops suddenly in a previously healthy patient who owns a cat. Treatment of uncomplicated central nervous system disease is generally supportive. Antibiotic therapy is reserved for patients with atypical or severe involvement, including encephalopathy and retinitis. Other internal and cutaneous manifestations of B. henselae infection have recently been described. These potentially life-threatening infections respond well to antibiotic therapy, even in immunocompromised patients.
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PMID:Cat-scratch disease and related clinical syndromes. 910 5

Streptococcus pneumoniae is the most common cause of pediatric invasive infections and an important cause of morbidity and mortality. In the past, S. pneumoniae responded universally to penicillin until nonsusceptible isolates were first noted in the 1960s. Before 1990, penicillin-nonsusceptible isolates remained a minor component of all reported isolates. Since that time, 20-30% of isolates in many centers in the United States and up to 50% of isolates in some other countries are penicillin-nonsusceptible. Of greater concern has been the development of isolates which are nonsusceptible to more than one antimicrobial agent. This review presents data on pediatric invasive pneumococcal disease in Arkansas and outlines the new treatment recommendations which have been developed in response to these problems. Streptococcus pneumoniae is an important pathogen worldwide and is considered the most common etiology of bacterial sinusitis, otitis media, pneumonia, meningitis and bacteremia. Before 1990, 95-96% of pneumococcal isolates were susceptible to penicillin. The first report of penicillin-nonsusceptible S. pneumoniae was made by Hansman and Bullen in 1967, who identified the strain in the sputum of a patient with hypogammaglobulinemia. Soon thereafter, penicillin-nonsusceptible pneumococci were reported in New Guinea and Australia as well. Over the last several years, the incidence of penicillin-nonsusceptible isolates has greatly increased. Of particular concern is the concomitant increase in the number of organisms that are nonsusceptible to more than one antimicrobial agent. Due to the development of such isolates, clinicians are having to approach patients with invasive disease due to pneumococci more cautiously. In an attempt to clarify confusion with terminology, the Centers for Disease Control and Prevention (CDC) have recommended the same nomenclature be used to classify resistance for all organisms: nonsusceptible organisms are those with an MIC (minimal inhibitory concentration) greater than or equal to that defined for the intermediate category of resistance and the term resistant should be reserved for those organisms with an MIC greater than or equal to that defined for the resistant category. Therefore, resistant isolates are a subgroup of the nonsusceptible isolates.
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PMID:The approach to treatment of invasive pneumococcal disease in the 1990s. 939 28


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