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)

Six children, out of twelve in a neonatal unit suffered from group D salmonellosis. Two patients presented in addition to intestinal manifestations massive extraintestinal symptoms, both with septicemia and meningitis. One patient died on the fourth day from massive disseminated intravascular coagulation and pyocephalus. The other patient had a complete recovery after an antibiotic therapy with chloramphenicol and ampicillin. As the source of infection the mother of case 1 was identified. In her stools salmonella group D were cultured. Cultures of the ward-personals, stool and the food were negative. It should be mentioned that only children fed with artificial food suffered from salmonellosis; whereas children on breastmilk had an unremarkable clinical course and consistantly negative stoolcultures.
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PMID:[Salmonella-meningitis in the newborn (author's transl)]. 46 Feb 61

A case of acute renal failure associated with disseminated intravascular coagulation occurring immediately post partum is reported. The aetiological role of the associated eclampsia together with evidence for a hypersensitivity reaction to ampicillin is discussed.
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PMID:Postpartum renal failure associated with eclampsia and penicillin hypersensitivity. 119 92

Typhoid accounts for 8% of pediatric admissions to the Aga Khan University Hospital in Karachi, Pakistan. Over a 4-year period (1986-1989), 355 children had typhoid documented by culture of blood or bone marrow. Strains of Salmonella, resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole accounted for 20% of these cases. Compared with children infected by drug-susceptible strains of Salmonella, children with multiresistant infection were generally sicker at presentation and were more likely to be assessed as appearing "toxic" (P less than .001), as having disseminated intravascular coagulation (P less than .01), and as exhibiting hepatomegaly (P less than .01). The mortality was 4.2% among children with multiresistant infection and 1.4% among those infected with strains susceptible to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole; the higher mortality in the former group was probably due to a longer duration of illness (P less than .05) and to ineffectual oral antimicrobial therapy before hospitalization.
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PMID:Multidrug-resistant typhoid in children: presentation and clinical features. 196 94

The enterococci, members of the group D streptococci and the predominant aerobic streptococci of the gastrointestinal and female genital tracts, have long been recognized as significant pathogens in infective endocarditis. Over the past 2 decades, enterococci have become increasingly important nosocomial pathogens, related to their intrinsic resistance to many antibiotics, especially the cephalosporins, and the greatly increased use of antimicrobial therapy in hospitals. Recent reports have documented an alarming increase in the frequency of high-level resistance to aminoglyclosides, and strains resistant to ampicillin by production of a beta-lactamase and to vancomycin have now been encountered. We have reviewed the clinical features and course of 153 cases of enterococcal bacteremia occurring in a university hospital over the 14-year period, 1970 to 1983, 1) to understand better the importance of enterococci as human pathogens, 2) to identify the clinical features of enterococcal bacteremia, 3) to isolate those findings that help to identify associated endocarditis, and 4) to develop guidelines for more effective antimicrobial therapy of bacteremic enterococcal infections. The annual incidence of enterococcal bacteremia in our center rose three-fold over the period reviewed. In 65 cases (42%), bacteremia was polymicrobial, caused by Enterococcus and at least 1 other microorganism, usually an aerobic gram-negative bacillus. Most bacteremias were nosocomial and derived from infections of the urinary tract (29 cases), intravenous catheters (24 cases), intra-abdominal infections or surgical wounds (46 cases), burn wounds (25 cases), or cholangitis (21 cases); only 1 case originated from a pneumonia. Endocarditis was identified in association with 12 of 35 community-acquired bacteremias, but only 1 of 118 bacteremias acquired in the hospital (P less than .001). Endocarditis was also significantly associated with pre-existent valvular heart disease and cryptogenic bacteremia, and was negatively associated with polymicrobial enterococcal bacteremia (no endocarditis in 65 cases, P less than .001). Isolated enterococcal bacteremia produced an indolent infection rarely associated with shock (3 of 64 cases evaluated, all cases due to valve destruction by endocarditis); conversely, with polymicrobial enterococcal bacteremia, primarily with gram-negative bacilli, shock or disseminated intravascular coagulation developed in 50% of cases (P less than .001).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Enterococcal bacteremia: clinical features, the risk of endocarditis, and management. 313 90

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

A delay of more than one month between the birth of twins is an unusual occurrence presenting the obstetrician and the neonatalogist with many questions regarding the management of the case. There is the risk of prematurity for the second twin as labor has already occurred in the pregnancy. There is also a risk of infection to both mother and fetus during the interval between the two deliveries, since the stump of the first twin's cord may precipitate ascending colonization from vagina and cervix. Germs frequently recovered from the vagina e.g. Ureaplasma urealyticum, are associated with prematurity. The latter has also been responsible for lethal interstitial pneumonia in the neonate. We present a case of a patient who though she delivered twice normally, had suffered 4 first trimester abortions and one late abortion, all spontaneous. Her eighth pregnancy was a twin pregnancy. She underwent a cerclage at 14 weeks, but went into labor at 17 weeks, when she delivered the first macerated twin. She was then treated with fenoterol and ampicillin; nevertheless she delivered twin the second at 26 weeks. This 750 g baby-girl presented with severe respiratory distress. Repeated chest X rays showed perihilar infiltrates which became nodular. All cultures were negative. At the end of the first week, when her condition was considered satisfactory, she deteriorated dramatically and died in respiratory failure and DIC. Tracheal aspirates were positive for Ureaplasma urealyticum.
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PMID:Fatal ureaplasma infection in second twin born 60 days after delivery of the first in a patient with recurrent spontaneous abortion--a case report. 378 90

Acute bacterial meningitis still represents a therapeutic problem. Successful management depends on early administration of large doses of bactericidal antibiotics and adequate treatment of complications, i.e. shock, acute cerebral edema, consumption coagulopathy, convulsions and electrolyte disturbances. Meningitis caused by Neisseria meningitidis or Streptococcus pneumoniae should be treated with benzylpenicillin. If benzylpenicillin cannot be given, chloramphenicol has remained the best substitute. However, cefuroxime or ceftriaxone now seems to offer an alternative to chloramphenicol. The prevalence of beta-lactamase-producing Haemophilus influenzae strains is increasing and chloramphenicol has replaced ampicillin in the treatment of H. influenzae meningitis. Recent studies indicate that cefuroxime, ceftriaxone or moxalactam may be as effective as chloramphenicol in this type of meningitis. In neonatal meningitis, cefotaxime or moxalactam may constitute alternatives to the present regimens with ampicillin-gentamicin, gentamicin-chloramphenicol, cotrimoxazole or gentamicin. Promising results have also been obtained with cefotaxime or moxalactam in elderly patients with meningitis due to Gram-negative enteric bacilli. However, more extensive studies are needed to determine the role of the newer cephalosporins in the treatment of acute bacterial meningitis.
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PMID:Treatment of acute bacterial meningitis with special emphasis on beta-lactam antibiotics. 659 56

A 27-year old woman admitted to the hospital after 5 days of vaginal bleeding at 12 weeks gestation had had a copper-T IUD inserted 10 months previously. The IUD string was no longer visible at pregnancy testing. Prior to admission she had experienced lower abdominal pain, increasingly heavy vaginal bleeding, fever, malaise, chills, and vomiting. Intravenous ampicillin and metronidazole were commenced and the uterus was evacuated under a general anesthetic. The copper-T was removed from the uterine cavity. A uterine swab at operation and preoperative blood cultures grew E. coli. A moderate degree of disseminated intravascular coagulation (DIC) was indicated by a coagulation profile. The case demonstrates that the copper-T may be associated with intrauterine sepsis and DIC. In the 1st trimester the risk of abortion following removal of a device is near 30%, while the rate of abortion for women in whom the string is no longer visible is near 48%. Patients presenting with pregnancy in the presence of an IUD and symptoms of sepsis should have the uterus evacuated under suitable antibiotic cover.
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PMID:Septic abortion in an IUCD user. 676 7

From January 1986 through February 1993, there were 16 episodes of respiratory infection due to Corynebacterium pseudodiphtheriticum in 13 patients. The ages of patients ranged from 24 to 77 years; the ratio of male to female patients was 3:1. One patient had three episodes of infection, and another patient had two. In one patient, who died of disseminated intravascular coagulation, the level of IgG was low. One patient was receiving prednisolone when the infection occurred. In two cases a mixed infection with Streptococcus pneumoniae was noted. Sputum cultures yielded C. pseudodiphtheriticum (> or = 10(7) cfu/mL). An increased neutrophil response in the sputum of infected patients was observed. Gram staining and electron microscopy of sputum showed phagocytosis of C. pseudodiphtheriticum by the neutrophils. ELISAs also showed an increase in the level of immunoglobulin against C. pseudodiphtheriticum after infection. Tests for determination of MICs of antibiotics revealed that C. pseudodiphtheriticum isolates were susceptible to ampicillin, amoxycillin/clavulanic acid, cefazolin, cefuroxime, ceftazidime, and imipenem. All strains were resistant to nalidixic acid; borderline susceptibility to ofloxacin, norfloxacin, and ciprofloxacin was noted. We suggest the use of beta-lactam antibiotics in the treatment of infection with C. pseudodiphtheriticum.
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PMID:Corynebacterium pseudodiphtheriticum: a respiratory tract pathogen. 772 68

From 1980-1990 245 immunocompetent patients were admitted to The Department of Infectious Diseases, Marselisborg Hospital with purulent meningitis or meningococcal septicaemia. The clinical diagnosis was established by clinical examination and by neutrophil pleocytosis. The aetiological diagnosis was established by demonstration of bacteria in the cerebrospinal fluid by microscopy or culture and by blood culture. Clinical signs of disseminated intravascular coagulation (DIC) or demonstration of meningococcal antibodies (MAT) in serum were considered diagnostic for meningococcal disease. The group comprised 120 males and 125 females aged 0-90 years. One hundred and eleven (45%) had meningococcal disease, 69 (28%) had pneumococcal meningitis, and 20 (8%) had H. influenzae-meningitis. Other aetiologies occurred in one to six cases. No aetiology could be established in 25 (10%) patients. Patients with meningococcal and pneumococcal disease were treated with monotherapy with high doses of penicillin, and H. influenzae-meningitis was treated with ampicillin. In patients with meningitis of unknown aetiology penicillin was used, except in children below the age of five where ampicillin was used. In patients with meningococcal disease the mortality was 5.4%, and 17% developed sequelae. In pneumococcal meningitis the corresponding figures were 13% and 17%, and in H. influenzae-meningitis 0% and 5% respectively. Among 20 patients with other aetiologies one patient (5%) died, and eight (40%) developed sequelae, whereas one patient (4%) died, and one (4%) developed sequelae in the group with meningitis of unknown aetiology. No ampicillin-resistant H. influenzae-strains were demonstrated. We suggest that monotherapy with betalactam-antibiotics is still a valuable treatment for meningitis in Denmark.
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PMID:[Purulent meningitis at the Marselisborg Hospital 1980-1990]. 781 15


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