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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two patients were treated with bone marrow transplantation and subsequently developed nonbacterial thrombotic endocarditis (NBTE). Both patients died of embolic sequellae and in neither was NBTE suspected antefinem. It is clear that NBTE occurs with increased frequency in bone marrow transplant (BMT) recipients and through arterial embolization contributes significantly to the morbidity and mortality of this procedure. In those at greatest risk, including BMT recipients, detection of disseminated intravascular coagulation; soft, changing systolic cardiac murmurs; hematuria; and signs of central embolic events suggest the diagnosis of NBTE. Awareness of the diagnosis of NBTE is essential for those who must interpret neurologic, myocardial and renal abnormalities in BMT recipients.
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PMID:Nonbacterial thrombotic endocarditis associated with bone marrow transplantation. 353 46

In an effort to ascertain important epidemiologic and prognostic risk factors, we analyzed 33 cases of Staphylococcus aureus meningitis occurring over an 8-year period (1976 to 1984). Staphylococcus aureus caused 6% of all bacterial meningitis at our University Hospital. Fifty percent of cases were pediatric and included 7 newborn infants, of whom 71% were either premature or had low birth weight. Major underlying diseases were: central nervous system (CNS) disorders (55%), endocarditis (21%, predominantly intravenous drug abusers), other sites of infection (27%), and prematurity (24%). Fifty-seven percent of patients were bacteremic and 41% of those had concomitant bacteriuria. Hypoglycorrhachia was present in 27% of cases, positive cerebrospinal fluid (CSF) Gram stain in 20%, disseminated intravascular coagulation (DIC) in 19%, and methicillin-resistant organisms in 18%. Cerebrospinal fluid cultures remained positive for a protracted period (mean, 6.7 days) regardless of the presence or absence of a CNS shunt. Overall mortality was 21%. Favorable outcomes were associated with the eventual presence of sterile CSF (15.4% vs. 100% mortality) and the removal of foreign bodies (10% vs. 67% mortality). Mortality was also associated (p less than 0.5) with the presence of diabetes mellitus, age greater than 60, obtundation or coma on presentation, bacteremia, or DIC. Cure correlated (p less than .05) with CNS shunt-associated infections, age less than 1, normal neurologic examinations on presentation, or the absence of DIC or bacteremia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Staphylococcus aureus meningitis: a broad-based epidemiologic study. 382 85

Patients with infective endocarditis and disseminated intravascular coagulation may require emergency valve replacement because of acute hemodynamic decompensation. After cardiopulmonary bypass is discontinued, nonsurgical hemorrhage, refractory to conventional treatment, may occur. The author describes a technique of mediastinal packing for temporary control of bleeding until the coagulation disorder can be corrected. The pack can be removed transcutaneously without reoperation. This method should be used only when all other approaches have failed to achieve hemostasis.
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PMID:Mediastinal packing for refractory nonsurgical bleeding after open-heart surgery. 388 2

Brucellosis, being eradicated among domestic animals in some countries, is still prevalent in some others where it poses a potential threat to the consumers of milk and cheese and those working with animals and meat. The patient presented below had contracted a severe and long-standing Brucella abortus infection by ingesting raw camel milk. She had signs of endocarditis and disseminated intravascular coagulation, but recovered when treated with tetracyclin and streptomycin.
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PMID:A case of brucellosis complicated by endocarditis and disseminated intravascular coagulation. 397 29

A pulmonary artery catheter was placed in a parturient whose 33-week gestation was complicated by severe preeclampsia and pulmonary edema. Cesarean delivery was performed for both maternal and fetal indications. During the second postoperative day the patient developed disseminated intravascular coagulation; subsequently she experienced sudden cardiopulmonary arrest and died. Autopsy revealed multiple pulmonary thromboemboli and trivalvular nonbacterial thrombotic endocarditis.
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PMID:Nonbacterial thrombotic endocarditis associated with severe preeclampsia and pulmonary artery catheterization. A case report. 402 Jul 93

Problems and limitations of medical management for infective endocarditis were studied and surgical indications were discussed based on the retrospective analysis of 55 episodes. Since perioperative complications still occur during highly active infection, antibiotic treatment was suggested as the primary management. Intractable or progressing heart failure appeared to be a definite indication for emergency surgery, but medical therapy was recommended for mild to moderate heart failure. For uncontrolled infection of more than one month duration despite the best available antibiotics, surgical debridement of the infected tissue was indicated. Occurrence of peripheral or fatal emboli was difficult to predict from clinical features and echocardiogram and therefore presented a therapeutic dilemma. Since major or fatal emboli frequently occurred during highly active infection, early initiation of effective antibiotic therapy was considered to be of primary importance. Demonstration of vegetation by echocardiography alone did not seem to justify urgent surgery. In addition, disseminated intravascular coagulation appeared to be a serious complication and thus sedimentation rate should be followed carefully. In the healed stage, prophylactic surgery seemed unnecessary for prevention of recurrent infection or embolization, as they were relatively rare.
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PMID:Medical management of infective endocarditis; limitations and indication for surgery. 402 Oct 66

Death resulted from the delayed onset of the acute respiratory distress syndrome and disseminated intravascular coagulation with left ventricular mural thrombus formation and nonbacterial thrombotic endocarditis approximately five days after an alleged attempted suicide by the ingestion of ten to twelve prolonged-action Ru-Tuss tablets. Although these lesions are thought to be similar in pathogenesis, this combination has not been previously reported in association with a drug overdose. The delay in onset is also of interest because of its clinical implications.
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PMID:Delayed fatal outcome after possible Ru-Tuss overdose. 610 86

Clinicopathologic correlations of nonbacterial thrombotic endocarditis (NBTE) were studied with special reference to their pathogenetic role in cerebral and myocardial infarction. In 2340 cases of consecutive autopsies of the aged, NBTE was observed in 217 cases or 9.3%. The age distribution of NBTE revealed a gradual increase with advancing age. The underlying diseases of NBTE were malignant neoplasm (51.6%), infection (28.3%) and other diseases (20.1%). The incidence of NBTE in each cancer was high in cancers of the colon (16.2%), pancreas (15.2%), gall bladder or bile duct (14.1%) and lung (13.0%). The vegetations of NBTE were found on the aortic valve in 46.1%, on the mitral valve in 40.6% and on the both valves in 8.3%. The incidence of myocardial infarction and scar was 51.2% in the NBTE group, while it was 38.6% in the non-NBTE control group (p less than 0.02). This difference was marked in patients with a small infarction (10.6% vs. 5.3%) and a myocardial scar (30.4% vs. 19.0%). The grade of coronary stenosis was less in the NBTE group than in the control group (p less than 0.001), suggesting that the origin of the myocardial ischemic lesion was embolism from NBTE. The incidence of large cerebral infarction was 14.7% in NBTE and 9.2% in the control group, and that of medium sized cerebral infarction was 35.0% and 23.6% respectively. In this latter group, cortical infarction comprised 57.9% in the NBTE group and 26.6% in the control group. In large cerebral infarction, cerebral atherosclerosis was less severe in NBTE than in the control group (p less than 0.001), also suggesting an embolic mechanism. Disseminated intravascular coagulation was found in 41.9% of NBTE.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Nonbacterial thrombotic endocarditis as a cause of cerebral and myocardial infarction. 648 38

Thirty-nine consecutive Staphylococcus aureus bacteremias were reviewed with particular attention to complications. Thirty-four (87%) of the bacteremias were nosocomial, with intravascular catheters (20 episodes) and dialysis-access sites (six episodes) the most common sources. Complications developed in 36% (14/39) of all bacteremias and in 30% (6/20) of those that were catheter-associated. Acute complications (shock, adult respiratory distress syndrome, disseminated intravascular coagulation) occurred in six patients and were fatal in four. In nine patients metastatic suppurative complications developed, six at sites of preexisting abnormalities. There were no episodes of endocarditis. Most patients received prolonged antibiotic therapy, and the majority of all suppurative complications required surgical intervention. Staphylococcus aureus bacteremia, even when not associated with endocarditis, is a cause of considerable morbidity and mortality in hospitalized patients.
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PMID:Complications associated with Staphylococcus aureus bacteremia. 670 26

We describe a 62-year-old man with diabetes mellitus and peripheral vascular insufficiency, with an ulcer on his foot which led to staphylococcal septicemia, endocarditis, and disseminated intravascular coagulation. All these factors contributed to thromboembolic occlusion of the terminal arteries and veins supplying the stomach, causing gastric infarction.
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PMID:Gastric infarction: a complication of endocarditis due to Staphylococcus aureus. 685 89


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