Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between 1987 and 1990, seven patients hospitalized in our hospital had bacteremia caused by Streptococcus bovis. Complete gastrointestinal evaluation was routinely carried out for digestive portal of entry and liver disease screening. In four cases (2 bacteremia, 2 endocarditis), a colonic growth was detected: sigmoid adenoma (n = 1) and rectosigmoid carcinoma (n = 4); in one case (endocarditis), several rectosigmoid carcinomas were associated with alcoholic cirrhosis; in one case (bacteremia), alcoholic cirrhosis was diagnosed; in one case (endocarditis), no gastrointestinal or hepatic portal of entry was found. These cases emphasize the need for simultaneous detection of endocarditis and gastrointestinal portal of entry such as colonic tumor and/or cirrhosis, in case of Streptococcus bovis bacteremia.
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PMID:[Prospective study of routine screening for cirrhosis and colonic tumors associated with Streptococcus bovis bacteremia]. 206 Jul 42

The frequency of mesangial IgA deposition was examined in 250 consecutive autopsy cases without known renal disease. Diffuse granular mesangial deposits of IgA were detected in 12 of 250 cases (4.8%). In six patients IgA deposits were associated with liver cirrhosis. Six patients (2.4%) suffered from various other conditions including endocarditis, bronchial asthma, cardiovascular disease, and neoplasia. Two of these patients had completely negative urine analysis on repeated investigations, whereas three patients exhibited microscopic haematuria and/or mild proteinuria. IgA1 was the major constituent in all specimens. C3c deposits in glomeruli were detected in one kidney. Our findings indicate that clinically overt renal disease is present in only a limited proportion of individuals with mesangial IgA deposits. Apparently, it represents the tip of an iceberg.
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PMID:Frequency of mesangial IgA deposits in a non-selected autopsy series. 251 84

To evaluate the clinical and microbiological features of infective endocarditis in patients with cirrhosis we compared 18 episodes of endocarditis in these patients with a control group of patients without liver disease. In 61% of patients with cirrhosis the origin of infection was unknown. Four patients developed endocarditis as a consequence of bladder catheterizations and two after hepatic biopsy. None of the four with previously known valvular heart disease had received antibiotic prophylaxis during these procedures. As compared with the control group, the patients with cirrhosis had more infections by enterococci (38.8% vs 11%; p less than 0.007) and non-viridans streptococci (38.8% vs 7.4%; p less than 0.001) and significantly less infections by viridans streptococci (11% vs 42.5%; p less than 0.01). The mortality rate associated with endocarditis was 38.8% and 22% in patients with and without cirrhosis, respectively (less than 0.1; NS). Infective endocarditis in patients with cirrhosis is often a complication of diagnostic or therapeutic procedures and has distinctive microbiological features.
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PMID:[Infectious endocarditis in patients with liver cirrhosis]. 262 60

Thirty cases of Listeria monocytogenes septicaemia occurred in Denmark between 1981 and 1986. The aim of this study was to consider the treatment of these patients, 18 males and 12 females aged from 20 to 87 years: average (AV) 65 years. One or more predisposing factors (PF) were found in 90% of the patients, mainly cancer (16), steroid treatment (12), cirrhosis and/or alcoholism (8), and diabetes mellitus (3). Follow-up varied from 3 months to 5 years. Ampicillin (AMP) alone or with an aminoglycoside (AMI) was the treatment in 9 and 16 cases, respectively. One patient was successfully treated with penicillin G and another received oral co-trimoxazol after recovered with carbenicillin plus AMI. AMP doses were lower than used in listerial meningitis (AV 5 g/day vs. 16 g/day), and the duration was variable: from one to 21 days (AV 8 days). The mortality rate was 50%. No significant differences between survivors and non-survivors were observed either in the antibiotic treatment (doses, duration, administration, and use of AMI), or the number and kind of PF found. The cause of septicaemia could not be established in most cases but 3 endocarditis, 2 perianal abscesses and one pericarditis were found in the non-survivors. Pulmonary involvement was present in 13 patients and CNS infection suspected in 10. Early diagnosis, adequate doses and duration of antibiotic treatment, and the use of drugs capable to penetrate purulent collections (microabscess and abscess formations) should improve the prognosis of L. monocytogenes septicaemia.
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PMID:The treatment of Listeria monocytogenes septicaemia. 263 5

Bacterial infection is a serious and often fatal complication of patients with liver disease and can prove fatal either directly or by precipitation of gastrointestinal bleeding, renal failure, or hepatic encephalopathy. At greatest risk are patients with alcoholic cirrhosis or decompensated chronic liver disease, or cases of acute liver disease who progress to fulminant hepatic failure or subacute hepatic necrosis. Infection appears to be unusual in patients with primary biliary cirrhosis. The site and type of infection is unrelated to the aetiology of the liver disease. Bacteraemia, pneumonia, urinary tract infection and spontaneous bacterial peritonitis are most common but infective endocarditis and meningitis, especially with pneumococci, are easily overlooked. Clinical suspicion of infection must be high as the only indication may be a general deterioration in the patients' clinical state, increasing encephalopathy or renal impairment. In the case of patients with fulminant hepatic failure, infection may precipitate the initial or recurrent encephalopathy and contributes to death in 10% of fatal cases. Spontaneous bacterial peritonitis is now recognized to occur in the absence of clinical features of peritonitis. The PMN content of the ascitic fluid may provide the only indication of infection and is the most readily available screening test. The most common types of organism responsible for all types of infection are Gram-negative enteric and streptococci, especially pneumococci, while infection with anaerobes is rare. Risk factors for infection include decompensated alcoholic liver disease, fulminant hepatic failure, gastrointestinal bleeding, invasive practical procedures and impaired host defence mechanisms against infection. Of the host defence mechanisms, impaired function of the reticuloendothelial system, complement, and PMNs represent the most common and serious defects. Defects of humoral immunity are present in ascitic fluid from patients with cirrhosis and are probably a major reason for development of spontaneous bacterial peritonitis. Diuresis improves these functions and reduces the risk of peritonitis. Treatment of infections even with the appropriate antibiotic is still associated with a high mortality but the use of adjuvant gut sterilization is promising, particularly in cases infected with Gram-negative enteric organisms. Infusions of fresh frozen plasma, blood and cryoprecipitate improve some systemic host defences and may be beneficial in the treatment and reduction of risk of infection.
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PMID:Bacterial infections complicating liver disease. 265 49

Seventeen cases of Infective Endocarditis diagnosed over a seven-year period by clinical-echocardiographic criteria in a Division of General Medicine are reviewed. More significant aspects regard the observation of the disease in some subjects at risk (elderly persons, patients with normal native valves affected by cirrhosis, by intravenous drugs abuse, by haematological neoplasms), the diagnostic difficulties in cases with oligosymptomatic or atypical beginning, and the frequent negative blood cultures. The value and the limitations of echocardiography and some aspects of therapy are discussed.
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PMID:[Current problems of infectious endocarditis. Clinico-diagnostic considerations on 17 cases]. 271 Oct 18

To examine the impact of the AIDS epidemic on morbidity and mortality in a defined population of intravenous drug users, we analyzed overall and cause-specific death rates, AIDS incidence, and acute medical hospitalizations among patients in a long-term methadone maintenance program in New York City for the years 1984 through 1987 (midyear population for each year 828 to 891; demographic characteristics did not differ). The number of deaths while in treatment increased from 11 (13.3/1000) in 1984 to 39 (44.2/1000) in 1987. Deaths from AIDS increased from 3.6/1000 to 14.7/1000, deaths due to bacterial pneumonia/sepsis from 3.6/1000 to 13.6/1000; deaths from cirrhosis, drug overdose, trauma, and other causes remained relatively stable. AIDS incidence rose from six cases/1000 in 1984 to 20.4.1000 in 1987. Hospitalizations for AIDS, pneumonia, tuberculosis, and endocarditis/sepsis increased from 84.9/1000 in 1986 to 144.8/1000 in 1987. These data suggest that the AIDS epidemic has had a profound effect on patterns of morbidity and mortality among intravenous drug users in this methadone program population. Drug treatment programs may be important sites for targeting clinical services for drug users with AIDS, although the increasing burden of AIDS-related disease will require expansion of existing funding and treatment resources.
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PMID:Impact of the AIDS epidemic on morbidity and mortality among intravenous drug users in a New York City methadone maintenance program. 278 2

The case is reported of a 66-year old man who developed Streptococcus bovis endocarditis on a fairly loose aortic stenosis and who also presented with alcoholic cirrhosis complicated by an ultimately lethal hepatoma. On this occasion, comments are made on the following points: -Str. bovis is increasingly responsible for bacterial endocarditis. This micro-organism is now rapidly and reliably identified. -Str. bovis endocarditis has some clinical features of its own. -Patients in whom the usual portals of entry of bacterial infection (i.e. benign or malignant tumours of the colon or rectum) cannot be identified should be investigated systematically for hepatic cirrhosis. -Drug sterilization of the gut is useful to prevent bacteremia of intestinal origin in cirrhotic patients.
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PMID:[Infectious endocarditis caused by Streptococcus bovis and alcoholic cirrhosis complicated by hepatoma]. 282 37

The purpose of this study was to determine the incidence of death as the initial manifestation of cholelithiasis. Records of patients who died or underwent cholecystectomy for gallstone-related disease at Duke University Medical Center between 1976 and 1985 were reviewed. Thirty patients died, six of whom (20%) had previous episodes of biliary pain and stone documentation. Twenty-four (80%) were asymptomatic (three with previous incidental diagnosis of cholelithiasis). Reason for admission included acute cholecystitis (nine), pancreatitis (eight), biliary pain (six), cholangitis (four), jaundice (one), and endocarditis (one). Three patients died of gallstone complications without surgical intervention; one patient had renal failure and two had septicemia. Other causes of death were: sepsis (seven patients), cardiac failure (six), pulmonary complications (four), renal failure (three), cerebrovascular accident (three), liver failure (two), pancreatitis (one), and gastrointestinal bleeding (one). During this period, 1731 cholecystectomies were performed without mortality. In this group, the patients were younger (50 +/- 8 years vs. 64 +/- 13 years, p less than 0.001), and had a lower incidence of cirrhosis (p less than 0.001) and diabetes (p less than 0.002). The sex ratio was inverted (p less than 0.001). This study demonstrates that death from gallstones is uncommon (three cases per year), as is death from their initial clinical manifestation (1.2%). The risk of death is two- and ninefold higher in patients with acute cholecystitis or acute pancreatitis. Age, cirrhosis, and diabetes are important determinants of outcome.
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PMID:Deaths from gallstones. Incidence and associated clinical factors. 291 58

Ten cases of bacterial endocarditis were observed in cirrhotic patients. In 7 cases, endocarditis was due to group D Streptococcus, 5 of which were Streptococcus D. bovis. Special features were the involvement of tricuspid valve and the involvement of two or more valves in 4 cases. Surgery was necessary in the acute phase in 5 patients: cure was definitely obtained in 8 cases after a particularly long interval. A colonic lesion could have been the portal of entry in some cases. Liver cirrhosis was considered as a predisposing factor for bacterial endocarditis, especially due to group D Streptococcus or to other bacteria of intestinal origin. This is probably related to the frequency of the colonic origin of group D Streptococcus endocarditis. Loss of filter function of the liver may partly explain the features of these forms of endocarditis.
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PMID:[Association of bacterial endocarditis and alcoholic cirrhosis in 9 patients]. 310 82


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