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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three years after splenectomy, a middle-aged woman had two separate episodes of fulminant bacterial sepsis. She recovered each time with prompt and appropriate treatment. Her immunologic system was examined and found to be normal with respect to antibody formation against diphtheria and tetanus toxoid, granulocyte killing of staphylococci and serum opsonizing activity. Granulocytes, bursa-equivalent (B) and thymus-dependent (T) lymphocytes and serum immunoglobulins were quantitatively normal. She produced antibody against subcutaneously injected polyvalent pneumococcal vaccine. She demonstrated cutaneous anergy. The literature on this syndrome was reviewed in an attempt to ascertain why hyposplenic patients are subject of fulminant bacterial, chiefly pneumococcal, sepsis. The probably explanation is the delayed production of antibodies against the phagocytic-resistant capsule of certain bacteria which the host had not previously encountered. The incidence of this syndrome appears to be on the order of 0.5 to 1.0%/year for splenectomized older children and adults. As the syndrome is seen chiefly in splenectomized or othewise hyposplenic patients, a causal relationship seems to exist.
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PMID:The syndrome of post-splenectomy fulminant sepsis. Case report and review of the literature. 2 19

Gallium-67 citrate imaging was carried out in 59 children from 3 mo to 20 yr of age. Indications for the study included the search for occult inflammatory disease and the detection and staging of malignant disease. The Ga-67 citrate scan had a 96% reliability in confirming or excluding the site of purulent material as a cause of sepsis, and 76% reliability in detecting malignant disease. Tissue distributions in children differ from those in adults primarily in that the epiphyseal plates, spleen, and thymus may show increased activity normally and in the presence of sepsis. These variations are illustrated as possible sources of incorrect interpretation. "Cold" defects may be seen in sterile collections and avascular masses. Experience in this age group seems sufficiently encouraging to continue the use of gallium-67 citrate for the purposes described.
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PMID:Gallium imaging in pediatrics. 19 33

In a 4 year experience with 7- postoperative or postinjury patients in liver failure, we found that 27 (37 percent) had associated bacterial sepsis. The mortality rate in this group of patients was 48 percent, compared with an average of 80 percent among patients with liver failure from other causes. Laboratory evaluation of cellular immune response in 20 cirrhotic patients confirmed the clinical observation of a relative failure of cellular immunity. Mitogen response of lymphocytes to phytohemagglutinin was significantly decreased in cirrhotic patients as was the number of thymus-derived lymphocytes. The association and poor prognosis of pre-existing liver damage, injury, bacterial sepsis, and liver failure is discussed. It is concluded that a postoperative or postinjury patient, regardless of his general condition, who has any possibility of having undrained intraperitoneal sepsis, deserves re-exploration since the trade-off for benefit usually far outweighs the possibility of doing harm. The decision for reoperation in such critically ill patients is not easy, but such operative aggressiveness is warranted.
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PMID:Liver failure in the postoperative patient: the role of sepsis and immunologic deficiency. 109 76

Analysis of prosector's findings and results of pathoanatomical studies of 65 cases who had died from sepsis showed that its incidence increased from 0.92% in 1956--1960 to 4.11% in 1971-1974. Along with the well-known typical manifestations of sepsis, a number of its perculiar features associated with application of modern therapeutic methods are considered: the prevailing form of sepsis is pyemia (81.5%), considerable incidence of sepsis following peritonitis and septic thrombophlebitis developing at sites of prolonged catheterization of veins. The significance of staphylococci and Bacillus pyocyaneus, which are resistant to the majority of the available at present antibiotics, as principle pathogenes of modern sepsis is emphasized. A dependence between the localization and size of metastatic foci and the kind of pathogene and nature of its toxines is noted. Among the conditions contributing to the development of sepsis the authors consider a reduction of the immunological reactivity of the organism morphologically characterized in the dead persons studied by the absence in lymphatic follicles of lymphatic nodes and the spleen, of "light" centres, drastic atrophic changes in the thymus gland in the majority of cases, and by slightly manifested phenomena of phagocytosis of microbes in the foci of inflammation. The role of operative and other traumas, the character of preceding diseases and application of immunodepressive therapy in the reduction of the immunological reactivity of the organism is tressed.
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PMID:[Pathological anatomy of present-day sepsis]. 120 Aug 80

The structure of thymus, spleen, adrenal and thyroid glands and changes in peripheral white blood cells formula were studied in 97 cases of sepsis and local inflammatory processes (LIP) in infants. A complex of differential diagnostic features of sepsis and LIP was defined. Mathematical use of the complex significantly increases the objectivity of sepsis and LIP diagnosis.
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PMID:[Sepsis and local inflammatory processes in infants: mathematical approach to pathomorphological differential diagnosis]. 185 78

Critically ill patients have increased rates of sepsis partly due to a down-regulated immune system. Nutrients may modulate the immune system. The following studies were performed to determine whether arginine is one of these "essential" nutrients for the immune system. Thirty-two male Sprague-Dawley rats (weighing 175 g) were divided into two groups that were pair-fed with either an elemental, arginine-supplemented enteral diet, or the same diet with arginine removed and replaced with glycine. Both diets were isocaloric, isoosmolar, and isonitrogenous. After 6 days on the diet, animals underwent testing. There were no significant differences between the arginine-supplemented and the arginine-free diet groups in blood glucose or hematocrit. The arginine-supplemented animals had higher serum albumin (4.1 +/- 0.1 mg/dL v 3.6 +/- 0.1 mg/dL; P = .035) and serum protein levels (5.2 +/- 0.1 mg/dL v 4.3 +/- 0.1 mg/dL; P = .041); and had higher thymus gland (0.53 +/- 0.03 g v 0.44 +/- 0.02 g; P less than .0001) and spleen weights (0.66 +/- 0.01 g v 0.57 +/- 0.01 g; P less than .01). Daily total urinary nitrogen excretion, nitrogen balance, and weight gain showed a tendency for the arginine-supplemented animals to retain more of their nitrogen calories. There was no difference in the amount of hydroxyproline (OHP) found in the wound cylinders of either group (both 25.6 micrograms OHP/cm polytetrafluoroethylene) but the arginine-supplemented group's wounds had greater wound bursting strengths (429 +/- 3 g/cm v 350 +/- 7 g/cm; P = .044).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The effects of an arginine-free enteral diet on wound healing and immune function in the postsurgical rat. 191 87

An autopsy study of glutaric aciduria type II in a 62-day-old Japanese boy is presented. The diagnosis was made by analysis of organic acids in the urine. Immunoblot analysis of liver homogenate confirmed the diagnosis, revealing absence of electron-transferring flavoprotein dehydrogenase. The major findings were fatty changes of variable degree in many organs and tissues, the most severe being found in cardiac myocytes, hepatocytes, renal tubular epithelium, and skeletal muscle fibers. Other pertinent findings included multicystic and dysplastic kidney, pulmonary alveolar proteinosis, and spongiosis and gliosis of the spinal cord. The thymus was markedly depleted, and lymphocytes in the lymph nodes were mainly B cells. Although some of these changes may have been secondary to the sepsis and immunosuppression complicating 2 months of intensive care, the abnormal organic acid metabolism with severe acidosis may have been a significant contributing factor.
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PMID:Glutaric aciduria type II: autopsy study of a case with electron-transferring flavoprotein dehydrogenase deficiency. 208 30

We performed clinicopathological studies on early-onset sepsis (5 infants, less than 72 hours of life, EOS) and late-onset sepsis (15 infants, greater than 72 hours, LOS) of very low birth weight, less than 1500 g (VLBW). In EOS, the clinical features mimic the respiratory distress syndrome and hematological changes were not observed. The lungs showed slight interstitial pneumonia with structural immaturity, hyaline membranes, hemorrhage, and minimal infiltration by polymorphonuclear neutrophils (PMNs). The pathogen was group B streptococcus or weakly gram-negative bacilli. In LOS, pneumonia proceeded to sepsis and neutropenia with elevated numbers of circulating immature neutrophils, and increased levels of C-reactive protein were observed at the onset of sepsis. Severe pneumonia with infiltration of numerous PMNs and bacterial colonies and polymicrobial infection by nosocomial pathogens such as Staphylococcus aureus and Pseudomonas aeruginosa were common. The thymus and spleen weights varied but retained normal structure in EOS. The thymus was depleted of lymphocytes, and the spleen was hypertrophic but poorly reactive against infection in LOS. The pathogenesis of EOS is regarded as being more closely correlated with lung immaturity and circulatory disorder in early life, whereas that of LOS is associated with immunological defenses of the host, potency of the pathogens, and terminal multiple organ failure.
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PMID:Clinicopathological differences between early-onset and late-onset sepsis and pneumonia in very low birth weight infants. 223 61

A newborn male infant with epidermolysis bullosa letalis died at age 6 weeks of septicemia. He had many congenital ectodermal abnormalities and a rudimentary thymus. The spleen had no germinal centers and the lymph nodes lacked follicles. Cytotrophoblast of the amniochorion was sparse and the amniotic epithelium was distorted. Immunohistologic studies of amniotic epithelium revealed the unprecedented presence of trophoblast antigens. Before birth of the patient, the parents had a 5-year history of infertility; after death of the patient, the mother sustained a ruptured tubal pregnancy that necessitated blood transfusions and surgical removal of the tube. She subsequently became pregnant a third time and was delivered of a normal child. The wife shared four major histocompatibility (HLA) antigens with her husband. The parents' immunogenetic characteristics and the immunopathologic features and extraembryonic membranes of the child are considered in terms of maternal responses to trophoblast antigens.
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PMID:Epidermolysis bullosa letalis: an immunogenetic disease of extraembryonic ectoderm? 327 96

Rabbits immunized intravenously(iv) with sheep erythrocytes(SRBC) (primary response) pass through a period which begins at about Day 35 postprimary immunization and extends to about Day 120 during which time all detectable spontaneous AFC (immediate PFC) and memory AFC(cells which generate PFC in culture) are detected only in the spleen. Prior to Day 30 postprimary iv immunization, large numbers of immediate PFC are detected in the circulation and the bone marrow as well as in the spleen. By Day 120 postprimary iv immunization, memory cells can be detected in significant numbers in the thymus and the popliteal lymph nodes (PLN) as well as in the spleen. The number of memory cells in the PLN and thymus increases over the course of the following 6 months. Rabbits splenectomized on Day 40 postprimary iv immunization and subjected to reimmunization iv with 10(9) SRBC 1, 5, or 8 months later were unable to give significant secondary immune responses. Only the thymus and PLN cells, cultured in vitro with the antigen(SRBC), 1, 5, or 8 months postprimary immunization, generated secondary immune(PFC) responses and these responses were feeble at best. The failure of the immunized rabbit to give a significant secondary immune response to SRBC if splenectomy was first carried out at a time postprimary iv immunization when all memory cells to the original antigen are sequestered only in the spleen (i.e., days 40 to 100) constitutes an animal model which provides a credible immunological explanation for the postsplenectomy syndrome which affects a minority of splenectomized individuals. These individuals, like the rabbits splenectomized on Day 40 postprimary immunization, lack the capacity to evoke a strong secondary immune response to particular infectious microorganisms and succumb in a few days with fulminant septicemia unless aggressive chemotherapy is instituted upon initial sign of infection.
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PMID:Cells involved in the immune response. XXXII. Surgical extirpation of the spleen in the early memory period following primary i.v. immunization of the outbred rabbit results in a marked impairment of a subsequent immune response to the specific antigen: an immunological explanation for the overwhelming postsplenectomy syndrome. 369 43


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