Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 60-year-old woman with rheumatoid arthritis developed acute emphysematous septic arthritis of the knee due to Klebsiella pneumoniae. She was brought to the hospital in septic shock with disseminated intravascular coagulation and had striking physical signs and roentgenograms showing distention of the knee with gas. She also had an infection of the hand with subcutaneous gas. After surgical drainage and institution of antibiotic therapy, she remained critically ill for several days but gradually improved. Two months later, she was ambulating independently. Emphysematous septic arthritis is rare. Four cases have previously been reported, but none were caused by Klebsiella.
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PMID:Emphysematous septic arthritis due to Klebsiella pneumoniae. 327 11

A breast-fed 25-day-old infant was hospitalized because of swelling and tenderness of the left leg, developed after mild rotary motion of the leg by his brother. Radiographic examination showed widening of the left articular hip joint space. On the day of admission, a presumptive diagnosis of septic arthritis was entertained, and antibiotic therapy was instituted. Following profuse bleeding from sites of skin punctures, coagulation studies were performed. Prothrombin time and partial thromboplastin time were prolonged. Administration of phylloquinone (vitamin K1) resulted in rapid normalization of coagulation. Differential diagnosis between hemarthrosis resulting from vitamin K deficiency and septic arthritis with disseminated intravascular coagulation is a matter of great importance in such patients.
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PMID:Vitamin K deficiency presenting with hemarthrosis. 649 Aug 91

This report outlines our experience with streptococcal toxic shock syndrome (STSS) at the Veterans General Hospital-Kaohsiung during the period October 1990 to November 1993. Group A streptococci were isolated from blood or normally sterile tissue in association with hypotension and multi-organ failure in the eight cases studied. A primary focus of infection was identified in seven cases, including pneumonia (1), septic arthritis (1) and soft-tissue infections (5). The remaining patient suffered from hyperglycemic hyperosmolar non-ketotic coma and Group A streptococcal bacteremia, without an obvious focus of infection. There were four cases of bacteremia. Clinical complications included acute renal failure in all eight cases, disseminated intravascular coagulation in five cases, liver involvement in two cases, adult respiratory distress syndrome in one case and soft-tissue necrosis in five cases. All isolates were sensitive to penicillin, and most patients were treated with intravenous penicillin G, with or without other antibiotics (gentamicin or clindamycin). Of the six patients with soft-tissue infection, two underwent amputation of the infected limb, and one patient underwent sono-guided pigtail drainage of psoas muscle abscess. Three of the patients died. STSS may be uncommon in Taiwan, but it is not rare. Early recognition of STSS (facilitated by Gram stain and culture), prompt debridement and drainage, and adequate antibiotic treatment with penicillin or clindamycin, or both, are necessary for control of such lethal infections.
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PMID:Streptococcal toxic shock syndrome in southern Taiwan. 760 78

The clinical features, essential laboratory findings, management, and outcome of all 23 cases of septic arthritis caused by different serogroups of beta-hemolytic streptococcus (BHS) seen at the Stanford Medical Center, Stanford, CA, from July 1, 1985, through October 31, 1996, were reviewed and compared to those found in the literature. Group A streptococci (GAS) accounted for 9 (40%) of our cases; group B (GBS), for 7 (30%); and Group G (GGS), for 7 (30%). No cases were caused by Group C (GCS) or F (GFS) during this period. During the same period, GAS accounted for 66 (33%) of 200 cases of bacteremia due to BHS, GBS, for 98 (49%); GCS, for 12 (6%); GFS, for 4 (2%); and GGS, for 20 (10%). A review of potential risk factors revealed that, with the exception of GGS, male and female patients were almost equally distributed among each of the serogroups. Patients aged 50 years and older comprised 56%-77% of each group. Associated conditions and risk factors were present among most patients (19/23, 83%); autoimmune diseases and a chronic skin wound or trauma were notably present among patients with GAS, while diabetes mellitus and malignancy were more common among patients with GBS. Infected prosthetic implants were present in 7 patients, including 4/7 patients with GGS. All patients had positive cultures of synovial fluid, and 11/23 (49%) had positive blood cultures (GAS, 5/9; GBS, 6/7; and GGS, 0/7). The clinical presentation and hospital course of patients infected with the different serogroups varied. Patients infected with GAS had the most severe disease and those with GGS the least severe. Necrotizing fascitis, shock, DIC, and admission to the intensive care unit were found only among patients infected with GAS. Despite aggressive management with antimicrobial therapy and surgery, 4/23 patients died (3 patients with GAS; 1 with GBS). The isolates from our patients were not available for study; investigations by others of the biology of BHS suggest that the production of 1 or more of the streptococcal pyrogenic exotoxins by isolates of GAS may account for the differences in the severity of disease among our patients with septic arthritis caused by different serogroups of BHS. Although septic arthritis due to BHS is uncommon, such patients provide a valuable model to study features of the host-parasite interaction that may contribute to the observed differences in severity of disease.
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PMID:Bacterial arthritis due to beta-hemolytic streptococci of serogroups A, B, C, F, and G. Analysis of 23 cases and a review of the literature. 955 3

This article describes the microbiology, diagnosis, and management of human and animal bite wound infections. Various organisms can be recovered from bite wounds that generally result from aerobic and anaerobic microbial flora of the oral cavity of the biting animal, rather than the victim's own skin flora. The role of anaerobes in bite wound infections has been increasingly appreciated. Anaerobes were isolated from more than two thirds of human and animal bite wound infections, especially those associated with abscess formation. This article describes several of the organisms found in the bites of various species. In addition to local wound infection, other complications may occur, including lymphangitis, local abscess, septic arthritis, tenosynovitis, and osteomyelitis. Rare complications include endocarditis, meningitis, brain abscess, and sepsis with disseminated intravascular coagulation, especially in immunocompromised individuals. Wound management includes the administration of proper local care and the use of proper antimicrobial agents when needed.
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PMID:Microbiology and management of human and animal bite wound infections. 1282 49

A 7-year-old castrated male German Shepherd Dog was evaluated for lethargy, icterus, and sepsis. Porcupine quills had been removed from the dog's face 1 month prior to examination; progressive right forelimb lameness had developed soon after removal of the quills. Septic arthritis of the right elbow joint was diagnosed and was unresponsive to antimicrobial and anti-inflammatory treatments. At the time of referral, the dog had developed endocarditis, septicemia, and disseminated intravascular coagulation. Via ultrasonography, a foreign body consistent with a porcupine quill was detected in the medial portion of the right humeroradial joint. The dog did not respond to initial supportive treatment and died as a result of cardiac arrest. Postmortem examination confirmed the presence of a quill in the medial compartment of the right elbow joint and severe acute endocarditis with septic emboli to the kidneys and spleen. Ultrasonographic examination should be considered as a diagnostic tool when septic arthritis secondary to a foreign body is suspected in dogs.
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PMID:Ultrasonographic diagnosis of septic arthritis secondary to porcupine quill migration in a dog. 1512 88

Necrotizing fasciitis is an uncommon manifestation of Salmonella infection. We report a case of Salmonella group D septic arthritis complicated with necrotizing fasciitis in a 51-year-old man who had noninsulin dependent diabetes mellitus and rheumatoid arthritis. He presented with fever and severe right hip pain complicated with septic shock and disseminated intravascular coagulation. Crepitation was noticed upon physical examination, and plain films showed numerous air bubbles in the soft tissue around the hip joint. Prompt antibiotic therapy and surgical management were performed with a successful response. The causative organism was Salmonella group D. Antibiotic was given in the total course of 3 months, and there was no relapse of salmonellosis after 2 years follow up. The differential diagnosis of causes of non-clostridial crepitant soft tissue and muscle infections must include Salmonella, especially in patients who have underlying diseases or are taking immunosuppressive drugs. Prompt management is needed to reduce mortality and morbidity. Long-term suppressive therapy may be needed to prevent relapse.
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PMID:Salmonella group D septic arthritis and necrotizing fasciitis in a patient with rheumatoid arthritis and diabetes mellitus. 1703 1

We report the case of an 18-year-old woman who was admitted to the medical intensive care unit in Innsbruck with severe septic shock and respiratory insufficiency following a prolonged infection of the upper airways (pharyngitis, sinusitis). Abscessing pneumonia and bilateral pleural empyema were diagnosed as focus. Cultures of pleural fluids were positive for Fusobacterium necrophorum. In addition to multiple organ dysfunction syndrome (acute lung injury, acute renal failure, disseminated intravascular coagulation), she developed tenderness in the right neck followed by septic arthritis of the right sternoclavicular joint a few days later. Further history revealed a previous period of infectious mononucleosis (EBV infection). The previously healthy patient eventually made a complete recovery after prolonged treatment in the ICU including antibiotic therapy and multiple surgical interventions and drainage. Lemierre's syndrome is characterized by severe infection, with pharyngitis, sepsis and thrombosis of the internal jugular vein, and is most frequently associated with upper airway infection with Fusobacterium necrophorum, often preceded by infection with Epstein-Barr virus which enables bacteria growing in the oral cavity to invade.
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PMID:Lemierre's syndrome following infectious mononucleosis. 1836 59

Animal and human bite wounds can lead to serious infections. The organisms recovered generally originate from the biter's oral cavity and the victim's skin flora. Anaerobes were isolated from more than two thirds of human and animal bite infections. Streptococcus pyogenes is often recovered in human bites, Pasteurella multocida in animal bites, Eikenella corrodens in animal and human, Capnocytophaga spp, Neisseria weaveri, Weeksella zoohelcum, Neisseria canis, Staphylococcus intermedius, nonoxidizer-1, and eugonic oxidizer-2 in dog, Flavobacterium group in pig, and Actinobacillus spp in horse and sheep bites. Vibrio spp, Plesiomonas shigelloides, Aeromonas hydrophila, and Pseudomonas spp can cause infections in bites associated with marine settings. In addition to local wound infection, complications include lymphangitis, local abscess, septic arthritis, tenosynovitis, and osteomyelitis. Uncommon complications include endocarditis, meningitis, brain abscess, and sepsis with disseminated intravascular coagulation especially in immunocompromised individuals. Wound management includes administering local care and using proper antimicrobial therapy when needed.
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PMID:Management of human and animal bite wound infection: an overview. 1969 83

We report the observation of a septic arthritis of the knee complicated within first 36 hours by multiorgan failure including acute respiratory distress syndrome (ARDS), heart failure, acute renal failure and disseminated intravascular coagulation (DIC). A diagnosis of staphylococcal arthritis was suspected confirmed by direct examination, and culture showed a Staphylococcus aureus sensitive to methicillin. The sample sent to the National Reference Centre for Staphylococci (Lyon, France) for genetic analysis confirmed the isolate positive for the PVL gene expression. The fulminating evolution of a septic S. aureus arthritis in an otherwise healthy man should probably evoke the possibility of LPV strain. Anti-PLV antibiotics with anti-staphylococcal activity, such as clindamycin and linezolid should be started without waiting for typing of the S. aureus strain.
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PMID:Evolution of a fatal septic arthritis caused by a Panton-Valentine leukocidin (PVL)-producing Staphylococcus aureus strain. 2383 6


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