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

Vibrio vulnificus is an extremely invasive gram-negative bacillus that causes bacteremia and shock. It should be suspected in any patient who is immunocompromised or has liver disease or hemochromatosis. Reduced gastric acidity may also increase the risk of infection if a patient presents with a history of ingesting raw shellfish (especially oysters) or trauma in brackish waters and skin lesions. Patients most commonly present with one of three clinical syndromes: primary septicemia, wound infection, or gastroenteritis. Treatment includes aggressive wound debridement, antibiotic therapy, and supportive care. Rapidly diagnosing and promptly initiating therapy are critical because V vulnificus infection is rapidly progressive and mortality approaches 100% if septic shock occurs.
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PMID:Vibrio vulnificus. Hazard on the half shell. 177 90

Hemochromatosis, or primary iron overload, is a variably expressed genetic metabolic disorder greatly modified by sex, age, diet, and alcohol consumption. Although a diagnosis has been made at the bedside by careful documentation of the slow resolution of subcutaneous iron pigment, clinical diagnosis is frequently overlooked, and even autopsy may fail to reveal hemochromatosis as the cause for cirrhosis. Genetic linkage studies have confirmed the extremely high prevalence of this disorder. Untreated patients may succumb to sepsis caused by organisms such as Vibrio vulnificus, Yersinia species, and others whose virulence is altered by iron availability.
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PMID:Hemochromatosis and infection: alcohol and iron, oysters and sepsis. 248 33

We present a patient with idiopathic liver hemochromatosis and mild secondary cirrhosis complicated by Yersinia sepsis and miliary liver abscesses proven by echography and CT.
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PMID:Ultrasound and CT of multifocal liver abscesses caused by Yersinia enterocolitica. 267 27

A fatal case of Yersinia enterocolitica septicemia which was complicated by unique hemosiderosis is reported. On admission, the patient had diabetes and showed unusual hyperferritinemia. Postmortem examination revealed that the liver was studied with abscesses, and Yersinia antigen was expressed in foamy macrophages within these abscesses. Moreover, the cadaver showed generalized hemosiderin deposition, which was mainly observed in the liver and, to lesser degrees, in the pancreas, spleen, lymph nodes, brain, thyroid and kidneys. Since there was no apparent cause of the hyperferritinemia and generalized hemosiderosis, consideration was given to possible primary hemochromatosis. However, no liver or pancreatic fibrosis was demonstrated. Kupffer cells were also loaded with hemosiderin, and therefore it was considered that these cells had lost their ability to phagocytize the microorganism adequately, leading to major liver involvement. Interestingly, hemosiderin deposits in the kidneys were mostly present in glomerular epithelial cells. To our knowledge, this unique presentation has not been previously described in humans.
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PMID:Fatal Yersinia enterocolitica septicemia complicated by unique hemosiderosis. A case report. 306 9

A case of fatal septicemia caused by Vibrio vulnificus and Clostridium bifermentans in a patient with subclinical liver disease is described. The patient appeared to recover from the infection initially after antibiotic therapy but finally succumbed to rapidly developing hepatic failure. Postmortem examination revealed hemochromatosis. The pathogenesis of the polymicrobial septicemia and hepatic failure is discussed in the light of the published literature.
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PMID:Acute hepatic failure precipitated in a patient with subclinical liver disease by vibrionic and clostridial septicemia. 321 97

A 67-year-old man with Escherichia coli bacteremia and meningitis was found to have hemochromatosis. To my knowledge this is the first documented case of E coli meningitis occurring in the setting of hemochromatosis. The case raises issues regarding the role of chronic liver disease in the pathogenesis of gram-negative sepsis and the impact of iron loading on host immunocompetence and bacterial virulence.
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PMID:Escherichia coli bacteremia, meningitis, and hemochromatosis. 389 40

Acute abdomen, irreversible shock and sudden death are a typical although infrequent complication in patients with hemochromatosis. The author presents a further case of this syndrome and discusses the two leading pathogenetic interpretations described in the literature: sudden release of ferritin, and endotoxin shock. Clinical and post-mortem findings from this patient and a review of 19 cases from the literature suggest that most patients with this syndrome die from a primary bacterial peritonitis with gram negative sepsis and endotoxin shock.
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PMID:[Acute abdomen with irreversible shock, a rare but typical complication of hemochromatosis]. 390 80

We analyzed the clinical data and liver histology for iron overload in 74 renal allograft recipients. Twenty of the 74 patients had histological evidence of hemosiderosis. Four patients had hemochromatosis. Of the 2 noninvasive diagnostic tests the serum ferritin level was more reliable than percent saturation of transferrin in predicting the histological diagnosis of hemosiderosis. Of the 20 patients with hemosiderosis 14 died either from liver failure or concomitant sepsis. Female patients and those who received long-term dialysis had higher susceptibility for developing hemosiderosis. Of the 6 patients treated with phlebotomies, the response was good in 4 and incomplete in 2. Hemosiderosis and hemochromatosis should be considered in the differential diagnosis of posttransplant liver disease. Intermittent phlebotomies if carried out early may prevent the progression of hemosiderosis to micronodular cirrhosis.
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PMID:Hemosiderosis and hemochromatosis in renal transplant recipients. Clinical and pathological features, diagnostic correlations, predisposing factors, and treatment. 390 17

Halophilic, noncholera marine Vibrio bacteria can cause septicemia, gastroenteritis, cellulitis, and necrotizing fasciitis. We describe six patients with necrotizing fasciitis and review 12 cases described previously. The 18 patients included 14 men and four women. Their ages ranged from 32 to 79 years (average 58.1 years). Eleven patients were older than 55 years. Nine infections were caused by V. vulnificus, three by V. parahaemolyticus, and one by V. alginolyticus. In five cases the Vibrio species was not identified. Twelve patients had associated conditions that might have made them more susceptible to these infections, such as cirrhosis, steroid therapy, hemochromatosis, and multiple myeloma. These infections usually occur in apparently insignificant wounds (puncture wounds, insect bites) exposed to sea water or fish. Treatment is by debridement and antibiotic therapy. Three patients required amputation to control the infection. Six (33.3%) of the 18 patients died.
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PMID:Necrotizing soft-tissue infections caused by marine vibrios. 401 3

The patient was a 59-year-old man who had been in hospital suffering from aplastic anemia with transfusion hemosiderosis. Sudden onset of weakness, shaking chills and headache was observed after his staying out overnight on July 25, 1981. His temperature was 39.3 degrees C and he complained of abdominal pain and abdominal distension. His blood pressure dropped to a dangerous level and tonic convulsions that had begun in the upper body gradually extended to the whole body and he died 23 hours after his return. V. vulnificus was isolated by the blood culture performed before death. During his stay away from the hospital, he had eaten raw cuttlefish, which was considered to be the source of infection. V. vulnificus is one of the halophilic marine vibrios and is isolated frequently in summertime from the sea foods and sea water near Japan. It has been disclosed that the presence of underlying diseases such as liver cirrhosis, hemochromatosis can predispose a person to fatal sepsis by V. vulnificus. In this case, besides leukocytopenia, the presence of hemosiderosis induced by many transfusions was considered to be a major cause leading to the fulminating course of the disease.
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PMID:[Fatal Vibrio vulnificus infection in a patient with aplastic anemia]. 667 24


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