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

Total parenteral nutrition (TPN) using glucose as nonprotein calories was associated with increases in O2 consumption (VO2) and CO2 production (VCO2). The magnitude of the changes was a function of the patient's clinical state and glucose load. Depleted patients showed a minimal increase in VO2, while VCO2 increased 23%. Minute ventilation (VE) increased 32%. Hypermetabolic patients (major trauma, sepsis) had a 30% increase in VO2 and a 57% increase in VCO2, while VE increased 71%. Patients with mild to moderate injuries (energy expenditure +/- 15% of normal) showed a 21% increase in VO2 and a 53% increase in VCO2, while VE increased 121%. Large carbohydrate intakes were associated with increases in CO2 production in all patients, while increases in O2 consumption were seen primarily in hypermetabolic patients. These changes suggest that the high glucose loads of TPN may be a physiologic stress.
JAMA 1980 Apr 11
PMID:Respiratory changes induced by the large glucose loads of total parenteral nutrition. 676 43

Over 12 months, 26 malnourished patients had 30 episodes of leukopenia while receiving total parenteral nutrition (TPN). There were 22 episodes of leukopenia associated with high temperatures (greater than 37.8 degrees C) A TPN-induced septicemia was the cause of fever in one patient. One patient with slight transient fever received no antibiotics, and 21 febrile patients were treated with various broad-spectrum antibiotics. The average duration of leukopenia was 6.9 days, and the average nadir of leukopenia was 789/cu mm. Eleven patients died during or within two weeks of the neutropenic episode. No deaths were related to TPN-induced septicemia. With proper care, TPN can be given to neutropenic patients without additional risk of sepsis.
JAMA 1980 Aug 15
PMID:Total parenteral nutrition in leukopenic cancer patients. 677 23

In the period 1973 through 1978, the New York City Department of Health serogrouped 648 isolates of Neisseria meningitidis and investigated 259 cases if meningococcal meningitis and meningococcemia. Although meningitis and septicemia were mainly due to groups B and C, groups Y and W-135 caused nearly one third of the cases. There was no difference in mortalities when disease caused by the classic groups A, B, and C was compared with disease caused by the new serogroups X, Y, Z, W-135, and Z'. Most isolates from the respiratory tract were from the new serogroups, especially Z and Z' (some from patients with pneumonia), as were most of those from the genitourinary tract, anal canal, and miscellaneous sites. Group X was infrequently seen. Although most of the isolations of these groups of N meningitidis are apparently from asymptomatic carriers, Y and W-135 do cause a substantial number of acute symptomatic infections, in particular, septicemia.
JAMA 1980 Nov 14
PMID:Meningococcal disease in New York City, 1973 to 1978. Recognition of groups y and W-135 as frequent pathogens. 677 3

Two separate outbreaks of Pseudomonas aeruginosa urinary tract infections (UTIs) were associated with cystoscopy or transurethral prostate resection. The first outbreak was identified after routine bacteremia surveillance demonstrated four cases of P aeruginosa septicemia in a three-month period. A six-month retrospective review of the microbiology records identified 14 cases of P aeruginosa UTI associated with urologic surgery instrumentation. The outbreak terminated after the implementation of two major control measures: (1) replacement of hexachlorophene solution with an iodophor solution for preparing patients and cleaning instruments before disinfection, and (2) weekly gas sterilization of cystoscopy instruments. The second outbreak, consisting of 11 cases of P aeruginosa UTI after transurethral resection of the prostate gland, occurred in a 187-bed community hospital. All available patient isolates were serotype 011, and culture of a rubber adaptor attached to the resectoscope also yielded growth of that serotype. The outbreak promptly terminated when the rubber adaptor was sterilized between cases.
JAMA 1982 Oct 01
PMID:Nosocomial Pseudomonas aeruginosa urinary tract infections. 680 69

Pasteurella multocida most commonly infects patients with animal contacts. Life-threatening systemic disease is distinctly uncommon in otherwise healthy persons and usually occurs in patients with chronic predisposing disease. Two cases of sepsis occurred in a cancer hospital, and we surmise that specific predisposing factors existed in our patients as in prior reported cases of sepsis in patients without cancer. These factors include animal contact, open wounds, and, most important, advanced hepatic disease.
JAMA 1983 Jan 28
PMID:Pasteurella multocida septicemia. Experience at a cancer hospital. 684 52

Fusobacterium necrophorum septicemia developed in five patients after an oropharyngeal infection. Four patients had sore throat or neck pain, and two had findings of jugular vein septic thrombophlebitis. Metastatic abscesses, including embolic pneumonia, empyema, septic arthritis, and osteomyelitis, also occurred. Four patients recovered and one died. Proper treatment requires recognition of the oropharyngeal source of the septicemia and its differentiation from endocarditis. Antibiotic therapy should be prolonged, and metastatic abscesses drained.
JAMA 1982 Sep 17
PMID:Fusobacterium necrophorum septicemia following oropharyngeal infection. 695 28

Eight patients required emergency laparotomy in the immediate postoperative period after coronary artery bypass (CAB). Cardiac complications were few and minor. Sepsis was the major cause of mortality. In the two patients who died, delay in operative management contributed to their deaths. The lack of cardiac causes of morbidity and mortality in our series and others suggests that a stable postoperative coronary bypass patient represents a better surgical risk than the same patient preoperatively. Therefore, aggressive management, including early laparotomy, for suspected intra-abdominal pathology after CAB is recommended to avoid uncontrollable sepsis and death.
JAMA 1980 Oct 17
PMID:Emergency laparotomy immediately after coronary bypass. 696 61

Many patients with immune thrombocytopenia require splenectomy to achieve remission. They are therefore at risk for postsplenectomy septicemia and should receive vaccination against Streptococcus pneumoniae. In experiment situations, antigens contained within this vaccine cell initiate a polyclonal B-lymphocyte activation and increased production of specific and nonspecific antibodies. In certain animal models, a polyclonal B-lymphocyte stimulatory response can trigger an autoimmune disorder. Two patients with immune thrombocytopenia had relapses of their immune thrombocytopenia after the administration of pneumococcal and influenza vaccines. These observations suggest that patients with a history of immune thrombocytopenia should be monitored after vaccination.
JAMA
PMID:Vaccination-Associated relapse of immune thrombocytopenia. 696 6

Five tests have been used in combination to diagnose neonatal sepsis. This study describes their use in 56 infants evaluated between 8 and 60 days of age, who had nonspecific signs of infection at presentation, as well as further evidence in 524 infants evaluated in the first week after birth. When two or more of the five tests had abnormal results (leukocyte count less than 5,000/ cu mm; immature/total neutrophils greater than or equal to 0.2; ESR greater than or equal to 15 mm/hr; latex C-reactive protein, positive; and latex haptoglobin, positive), a "sepsis screen" was considered positive. A positive screen was found in 23 infants, ten of whom had proved sepsis, and only two had no evidence of infection. With the addition of a leukocyte count greater than 20,000/cu mm, the remaining two cases of sepsis would have been detected. In those with a negative screen (n = 33), 26 had no evidence of infection. The sepsis screen seems to be a useful adjunct in the diagnosis of neonatal sepsis during and beyond the first week.
JAMA
PMID:Detection of neonatal sepsis of late onset. 705 52

From 1955 to 1979, in Rochester, Minn, 193 residents with a mean age of 46 years underwent splenectomy. Only two cases of fulminant sepsis were documented during the 1,090 person-years of follow-up (0.18 cases per 100 person-years) in this unselected population. The incidence of any type of serious infection subsequent to splenectomy was estimated at 7.16 infections per 100 persons-years of follow-up (78 cases). The incidence of infections was significantly increased among patients undergoing incidental splenectomy in conjunction with abdominal operations for malignant neoplasms or other conditions. Immunosuppression, radiation, and chemotherapy also significantly increased the risk of subsequent infection. The low risk of fulminant sepsis after splenectomy in the general adult population justifies a policy of individualization of each case as to the relative merits of splenectomy v splenic preservation.
JAMA 1982 Nov 12
PMID:Postsplenectomy sepsis and mortality in adults. 713 80


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