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

Five episodes of nontyphoid salmonella infection following total hip replacement in four patients were studied. In three patients the infection occurred in the immediate postoperative period while prophylactic antibiotics were being administered. The fourth patient had bilateral total hip replacements five years apart with two nontyphoid salmonella infections, one immediately after the first operation (during antibiotic prophylaxis) and the second four years after the second operation. In addition to local infection, clinical manifestations included fever (all patients), diarrhea (three patients), deep prosthetic infection (two patients), and shock with disseminated intravascular coagulation and acute renal failure (one patient). In addition to antibiotic therapy, removal of the prosthesis was necessary for cure in three patients. All patients recovered. Hematogenous spread was thought likely in all cases. Four of five salmonella isolates were resistant to ampicillin and chloramphenicol. A review of the English-language literature yielded information on five additional cases of nontyhpoid salmonella infection after total hip replacement in four patients.
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PMID:Nontyphoid salmonellosis in patients with total hip replacement: report of four cases and review of the literature. 354 Nov 30

Eight cases of pulmonary involvement were observed in 17 severe cases of ictero-haemorrhagic leptospirosis. Haemoptysis (7 cases) occurred on the 4th day of the infectious syndrome and was associated with other haemorrhagic manifestations in 4 cases. Cough, pain and polypnoea were not constant. Chest X-ray showed diffuse, non-specific changes, such as nodular opacities or infiltrates. Septicaemia was confirmed in all cases with acute renal failure in 7 cases and meningitis in 6 cases. Severe thrombocytopenia was demonstrated in 2 cases. Six patients recovered quickly with regression of the lung changes within 12 days. Two patients died, one of a fulminant haemoptysis related to a disseminated intravascular coagulation syndrome, and the other of acute respiratory failure. All cases were confirmed serologically. Although lung changes in leptospirosis are usually benign and mild, haemoptysis and polypnoea with diffuse radiological changes are poor prognostic factors. The pathological changes were similar to those of haemorrhagic alveolitis. These changes may be either due to the liberation of toxins or to an immunological phenomenon.
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PMID:[Pulmonary manifestations in severe ictero-hemorrhagic leptospirosis]. 363 26

Heparin has been proposed following the supposed role of disseminated intravascular coagulation (DIC) in the pathologies associated with the consumption coagulopathies such as obstetric acute renal failure (ARF), whilst antifibrinolytic agents could be advocated to stop a simultaneous triggered fibrinolysis. Out of 26 obstetric ARF DIC may be demonstrated in 10 and supposed in 6 patients who developed severe post-partum uterine bleeding. Therapeutic schedules employing heparin or antifibrinolytic agents early post-partum do not seem to change either the behaviour of laboratory parameters (showing a DIC partial resolution within 48 hours), or heavy bleeding in respect to the patients treated with supportive therapies alone. Furthermore, heparin administered during the following days does not seem to be a crucial factor in the renal recovery, and is often followed by severe haemorrhagic complications. Fresh frozen plasma after aprotinin is able to stop bleeding in the presence of persisting signs of consumption without damaging renal recovery.
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PMID:Clinical and therapeutic correlations in consumption coagulopathy of obstetric acute renal failure. 370 33

Various biochemical and structural changes affecting the newborn's wellbeing develop as a result of perinatal asphyxia. Central nervous system abnormalities are frequent complications with high mortality and morbidity. Cardiac compromise may lead to dysrhythmias and cardiogenic shock. Coagulopathy in the form of disseminated intravascular coagulation or massive pulmonary hemorrhage are potentially lethal complications. Necrotizing enterocolitis, acute renal failure, and endocrine problems affecting fluid electrolyte balance are likely to occur. Even the adrenal glands and pancreas are vulnerable to perinatal oxygen deprivation. The best form of management appears to be anticipation, early identification, and prevention of potential obstetrical-neonatal problems. Every effort should be made to carry out effective resuscitation measures on the depressed infant at the time of delivery.
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PMID:Asphyxia neonatorum. 371 11

Early postpartum disseminated intravascular coagulation (DIC) was demonstrated by serial coagulation studies in 10 cases of acute renal failure (ARF) following obstetric complications (6 abruptio placentae, 3 retained placental fragments, 1 prolonged intrauterine fetal death). DIC abated within 48 hours irrespective of the therapeutic schedules employed. Renal damage was evidenced by a varying number of days of oligoanuric (6 cases) or polyuric (4 cases) ARF which always required dialytic treatment. Full renal recovery occurred in 9 cases. One patient died and no histological studies were performed. Renal damage seemed to correlate less with DIC than with the degree of anemia and shock.
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PMID:Acute renal failure in obstetric complications. 377 88

A case of severe acute intravascular haemolysis occurring after surgical repair of an abdominal aortic aneurysm in a 60-year old patient is reported. The operative conditions were difficult, requiring three laparotomies within 24 h, with rapid and profuse transfusion: 20 units of red blood cells, 31 of colloids, 11 units of fresh frozen plasma, 31 of diluted albumin and 41 of crystalloid solution. Evolution of the haemolysis became rapidly favourable under symptomatic treatment: forced diuresis (11.91 per 24 h) and alkalinization. None of the classic complications (acute renal failure, disseminated intravascular coagulation) arose. After review of various causes of severe acute intravascular haemolysis, its origin was probably mechanical in this case.
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PMID:[Severe acute intravascular hemolysis in a surgical hemorrhagic context]. 381 52

A case is reported of amoxapine overdose followed by acute rhabdomyolysis and myoglobinuric acute renal failure. There was disseminated intravascular coagulation and later hypercalcaemia. The patient recovered.
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PMID:Acute renal failure secondary to non-traumatic rhabdomyolysis following amoxapine overdose. 386 31

A farmer's wife who had helped with lambing aborted spontaneously in March after a short febrile illness in the 28th week of her pregnancy. She developed disseminated intravascular coagulation post partum with acute renal failure and pulmonary oedema. Recovery was complete after two weeks of hospital care. A strain of Chlamydia psittaci, probably of ovine origin, was isolated from the placenta and fetus. The patient's serum showed rising titres of antibody against chlamydia group antigen; the placental and fetal isolates; and a known ovine abortion, but not a known avian, strain of C psittaci. IgG against both ovine abortion and enteric strains of C psittaci was detected, but IgM against only an abortion strain was detected. Histological examination showed pronounced intervillus placentitis with chlamydial inclusions in the trophoblast but no evidence of fetal infection or amnionitis. Laboratory evidence of chlamydial infection was found in an aborting ewe on the farm in January and in remaining sheep and lambs in July. Doctors should recognise the possible risk to pregnant women in rural areas where chlamydial infections in farm animals are widespread.
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PMID:Abortion due to infection with Chlamydia psittaci in a sheep farmer's wife. 391 85

Three cases of hypotension are described that followed rapid evacuation of persistent unilateral pneumothorax. Common features included the presence of a pneumothorax for approximately one week before treatment commenced and profuse unilateral reexpansion edema, a rising hematocrit reading, hypotension, and anuria after evacuation of the pneumothorax in spite of a relatively normal pulmonary capillary wedge pressure. In one case, cardiac output was measured and found to be low (1.54 and 1.65 L/min/sq m), with a pulmonary capillary wedge pressure of 10 to 14 mm Hg. Death due to cardiovascular collapse occurred in one patient; ischemic colitis, acute renal failure, disseminated intravascular coagulation, and ischemic necrosis of both humeral heads occurred in another. The cases presented and the literature reviewed suggest that cardiovascular compromise was the end result of the combined effects of intravascular volume depletion and myocardial depression.
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PMID:Reexpansion hypotension. A complication of rapid evacuation of prolonged pneumothorax. 394 Jul 93

By damaging cell membrane integrity, acute rhabdomyolysis leads to electrolyte shifts according to the concentration gradients and the liberation of intracellular substances. Diagnosis is confirmed by the presence of a high serum creatinkinase activity (CK) and myoglobinuria. For clinical purposes myoglobinuria is demonstrated by a blood-positive dipstick in the absence of hematuria or hemoglobinuria. Rhabdomyolysis is usually acquired and is rarely due to hereditary enzyme defects. The authors report on 61 patients admitted in the last 15 years with rhabodomyolysis. In the past 4 1/2 years the diagnosis was suggested by CK greater than 5000U/1 in 49 patients, representing 1.6% of all admissions in the departments of medicine and surgery. Originally described in crush situations, rhabdomyolysis has been observed with increasing frequency as a consequence of muscular stress and self crush due to coma or hemi- and paraplegia during the last decades. 24% of the patients with this diagnosis had had an intoxication, and in 70% there were multiple simultaneous causes. Autoimmune diseases, infections of bacterial, viral and fungal origin, endocrinopathies, and thermic and ischemic injuries can also provoke rhabdomyolysis. As a consequence of fluid shift into the damaged muscle a compartment syndrome may lead to vascular or neural defects. In 80% of cases there is initial hypocalcemia, turning later into hypercalcemia. Other frequent electrolyte disorders accompanying rhabdomyolysis are hyperkalemia, hyperphosphatemia and a widened anion gap. 6 of 13 patients showed the typical blood changes found in patients with disseminated intravascular coagulation. Acute renal failure developed in 30 patients, 15 of whom underwent dialysis or hemofiltration.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Acute rhabdomyolysis]. 395 76


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