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

An experimental study of 20 patients with appendicitis was carried out in order to know if after the appendectomy they tolerate the hidratation with rehidratant salts by mouth in place of endovenous hydratation. The oral hydratation was indicated in all the cases immediately after the operation and only was one failure (5%). In the 95% the oral hydratation was tolerated, 45% without gastric symptoms, 35% with mild gastric symptoms and in 15% with moderate gastric symptoms. The association of gentamycin-metronidazol administered by intramuscular and oral way respectively was used in 100% of the patients. In 80% as profilaxis and in 20% as treatment. Two cases had complication as sepsis of the wound one of the profilactic group (5.9%) and another of the treatment group. In conclusion the oral hydratation with rehydrating salts were tolerated for the patients immediately after the appendectomy.
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PMID:[Oral rehydration immediately after appendectomy]. 251 42

When prophylactic antibiotics are used in abdominal surgery it is customary to give the first dose before the operation. Whilst intra-operative antibiotics may be effective in elective surgery, there may be an advantage to starting pre-operatively when there is already an infective focus such as appendicitis. Antibiotics started pre-operatively (group P) have been compared with antibiotics started after initial abdominal exploration (group T). Three intravenous doses of 500 mg metronidazole plus 1 g cephazolin were given in a randomized, double-blind study of 700 emergency and elective high-risk abdominal operations. Antibiotic plasma concentrations at the end of the operation were significantly lower in group P but lay well within the therapeutic range. Wound infection rates, which included minor and delayed infections, were similar in both groups (group P, 57 of 342, 16.7 per cent; group T, 55 of 358, 15.4 per cent; 95 per cent confidence intervals for the difference being -4.1 to +6.7 per cent. In appendicitis, wound infection rates were 12.1 and 13.9 per cent for groups P and T respectively. However, non-fatal deep sepsis was more common in group P (nine cases) than in group T (two cases) (chi 2 = 4.9, P less than 0.05). Postoperative infection was twice as common in obese patients whose body mass index (BMI) was greater than or equal to 26 (39 of 132, 30 per cent) than in thin patients whose BMI was less than 24 (41 of 288, 14 per cent; chi 2 = 13.8, P less than 0.001). This study failed to show any advantage to starting antibiotics pre-operatively, even in appendicitis.
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PMID:Timing of prophylactic antibiotics in abdominal surgery: trial of a pre-operative versus an intra-operative first dose. 264 13

Appendicectomy was performed on 100 patients with complicated appendicitis through a grid-iron incision. All patients received systemic metronidazole and cephazolin sodium which started preoperatively and continued postoperatively for 5 days. At operation, patients were allocated randomly to receive either local instillation of metronidazole and cephazolin intraperitoneally and interparietally (group A) or no local antibiotic therapy (group B). All wounds were closed primarily without drainage. Postoperative wound sepsis occurred in four (8%) of the 50 patients in group A and in 17 (34%) of the 50 patients in group B. One patient in group B developed pelvic abscess in addition to wound sepsis. The mean duration of postoperative hospital stay was 6.6 days (s.d. 2.98) in group A and 8.7 days (s.d. 5.55) in group B. These differences were statistically significant. No adverse reaction was noted. The conclusion of this study is that a single peroperative instillation of metronidazole and cephazolin into the peritoneum and wound layers is a safe and valuable adjunct to the perioperative systemic administration of these drugs in significantly reducing postoperative sepsis and duration of hospital stay in complicated appendicitis.
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PMID:Systemic plus local metronidazole and cephazolin in complicated appendicitis: a prospective controlled trial. 265 63

Intraabdominal sepsis is frequently seen following penetrating or blunt abdominal trauma as well as with perforated appendicitis or diverticulitis. The initial leakage of endogenous gastrointestinal microflora into the peritoneal cavity results in peritonitis and secondary septicemia, which often results in a localized intraabdominal abscess. These infections are commonly polymicrobial and correlate directly with the unique endogenous microflora at various levels of the gastrointestinal tract. The successful treatment of intraabdominal sepsis is primarily associated with prompt, appropriate surgical intervention. Parenterally administered antibiotics are also required to decrease the incidence of local bacterial infection or septicemia. The choice of the appropriate agent(s) to be used initially, before obtaining the results of culture and sensitivity tests, depends primarily on both the clinical presentation and on whether the intraabdominal infection occurred in the community or as a result of hospitalization. Clinical and experimental studies of intraabdominal sepsis have primarily emphasized the use of antibiotic agents that have a spectrum of activity effective against aerobic coliforms and the anaerobe Bacteroides fragilis.
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PMID:The treatment of intraabdominal infections in surgery. 268 20

A protocol was established aimed at limiting the duration of antimicrobial therapy in two patient groups with peritonitis. One group had perforated or gangrenous appendicitis and the other non-appendiceal disease. The duration of treatment given to patients treated according to the protocol was compared retrospectively to that of similar patients treated without the protocol. Patients with perforated or gangrenous appendicitis required significantly less antimicrobial therapy than those with peritonitis due to non-appendiceal disease. In non-appendiceal intra-abdominal sepsis the use of the protocol was associated with a significantly reduced duration of antimicrobial therapy, compared with that observed without the protocol.
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PMID:Evaluation of the use of a protocol in the antimicrobial treatment of intra-abdominal sepsis. 285 23

The efficacy of a single 500 mg intravenous intra-operative dose of metronidazole in the prevention of postoperative wound infection, following appendicectomy for acute mural appendicitis, was studied in a prospective randomized placebo controlled trial. Fourteen of the 96 patients (14.6%) in the metronidazole group and 13 of the 94 in the placebo group (13.8%) developed postoperative wound infection. Late sepsis was noted in 4 out of the 96 patients in the metronidazole group and in one of the 94 patients in the placebo group. This study suggests that a single intra-operative dose of metronidazole dose not reduce the incidence of postoperative wound infection following appendicectomy for acute mural appendicitis.
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PMID:Metronidazole prophylaxis in acute mural appendicitis: failure of a single intra-operative infusion to reduce wound infection. 289 54

The safety and efficacy of a single daily dose of netilmicin plus metronidazole after appendicectomy for gangrenous and perforated appendicitis was compared with the traditional thrice daily dosage. Twenty patients were enrolled in each group. The antibiotics were given intramuscularly for seven days after operation. Eradication of infection was observed in all patients and the postoperative wound sepsis was the same for each group. A significantly higher peak serum netilmicin level was achieved in the group receiving a single daily dose but nephrotoxicity was not observed. We concluded that the single daily dose of netilmicin was well tolerated and was as efficacious in this small series as the thrice daily regimen. The single-dose regimen has the advantage of simplicity and potentially increased bactericidal activity.
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PMID:Once daily administration of netilmicin compared with thrice daily, both in combination with metronidazole, in gangrenous and perforated appendicitis. 317 Mar 92

Unusual infections associated with colorectal tumors may, in some instances, be the sole clue to the presence of a malignancy. The infections are either related to invasion of tissues or organs in close proximity to the tumor or secondary to distant seeding by transient bacteremia arising from necrotic tumors. Seven patients seen at one hospital over a 5-year period illustrate the clinical presentations of such infections. The infections identified in these seven patients include endocarditis, meningitis, nontraumatic gas gangrene, empyema, hepatic abscesses, retroperitoneal abscess, clostridial sepsis, and colovesical fistulae with urosepsis. A computer-assisted search of the English-language literature and cross-checks from other review articles identified other infections associated with colon cancer, which include nontraumatic crepitant cellulitis, suppurative thyroiditis, pericarditis, appendicitis, pulmonary microabscesses, septic arthritis, and fever of unknown origin. The clinical importance of these infections and their correlation with colorectal malignancies are reviewed.
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PMID:Unusual infections associated with colorectal cancer. 328 64

Eight patients with a pyogenic infection of the sacroiliac joint are compared to 200 published cases. In all our patients the disease began with fever and immobilizing low back and buttock pain. All had bacterial growth in the blood cultures. Five out of 6 patients did not show inflammatory signs in the initial plain roentgenogram. Tc-99m scan was initially positive in 4 out of 6 patients. In 2 patients only the second scan, at 13 and 15 days respectively, was positive. All but one patient had a 4-6 week course of intravenous antibiotics. Three patients underwent surgery for abscesses or intraarticular sequestra. One patient with a small psoas abscess had only medical treatment under CT monitoring. All the patients recovered. From our observations and the literature we conclude that pyogenic sacroiliitis is often not recognized initially. Wrong diagnoses such as sepsis of unknown origin, appendicitis, discal hernia etc. can be avoided if pyogenic sacroiliitis is sought in a systematic fashion. The clinical diagnosis can be confirmed by bone scan, to be repeated at a later stage of disease (i.e. two weeks after onset) if the first examination is inconclusive.
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PMID:[Pyogenic sacroiliitis. Review of 8 personal cases and 200 cases from the literature]. 329 Nov 6

A retrospective review of cecal and appendiceal complications occurring in young patients with acute leukemia since 1969 was performed. The objective of this study was to determine the relative incidence of appendicitis and typhlitis among patients with acute leukemia who had operation or autopsy in this institution as well as to determine the risks of operative intervention. Fifteen patients with these complications were identified among the 400 patients with acute leukemia seen during this time period. Signs and symptoms of an acute abdomen were present despite immunosuppression. The incidence of sepsis at the time of presentation was 53%. Preoperative risk factors identified most frequently were coagulopathy and organ failure resulting from sepsis. Postoperative morbidity (25%) and mortality rates (8%) were related to the development of infectious complications. Appendicitis occurred in eight of the 15 patients studied, whereas typhlitis or its complications was found in seven patients. No preoperative factors could be found to differentiate typhlitis from appendicitis on clinical examination. It is suggested that operation can be safely performed in neutropenic patients who have acute right lower quadrant pain and signs of peritoneal irritation and may be the only effective way of differentiating appendicitis from typhlitis.
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PMID:Right lower quadrant pain in young patients with leukemia. A surgical perspective. 331 27


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