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

Gonococci do not readily cause disseminated infection in mice. To simulate some of the conditions leading to disseminated gonococcal infection in women, we suspended gonococci in mucin plus hemoglobin and studied the development of gonococcal bacteremia. The mucin-hemoglobin mixture was used because the menstruum appears to be involved in dissemination of gonococci from the genital tract during menstruation. Mice did not die after massive inocula of 10(9) gonococci given intraperitoneally in broth, but when gonococci were suspended in mucin (15%) alone, the 50% lethal dose was 10(8.4) and in 15% mucin plus 4% hemoglobin (M/H), the 50% lethal dose fell to 10(6.6). Sublethal doses produced local peritonitis and transient bacteremia. With larger inocula the local peritoneal infection progressed to fatal septicemia. Studies of the mechanism by which M/H lowered the 50% lethal dose showed that systemic clearance mechanisms were compromised, but not enough to account for the total decrease in the 50% lethal dose. If gonococci were given intravenously after intraperitoneal inoculation of M/H, sequestration of gonococci in the peritoneal cavity occurred, suggesting an effect on local peritoneal defenses. The effect on neutrophils appeared most significant, since numbers of neutrophils in the peritoneal fluid were decreased in the presence of M/H and neutrophils were destroyed by M/H in vitro. The serum bactericidal system was not affected. We conclude that M/H promotes gonococcal bacteremia by interference with phagocytosis and intracellular killing of gonococci. The model simulates the disseminated gonococcal infection cases in women which follow pelvic inflammatory disease in its progression from local peritonitis to transient or lethal bacteremia and in factors (mucin and hemoglobin) which enhance infection.
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PMID:Disseminated gonococcal infection in mice. 52 60

The protective efficacy afforded by immunization with the capsular antigen of Bacteroides fragilis against abscess formation and bacteremia due to this organism was studied in an experimental rat model of intraabdominal sepsis. Of unimmunized animals, animals immunized with methylated bovine serum albumin and complete Freund's adjuvant, and animals immunized with lipopolysaccharide of Bacteroides thetaiotaomicron, greater than 90% developed abscesses when challenged intraperitoneally with strains of B. fragilis or Bacteroides distasonis (given with an enterococcus) or with the cecal contents of meat-fed rats. In contrast, animals immunized with B. fragilis capsular polysaccharide, given with or without methylated bovine serum albumin and complete Freund's adjuvant, and animals immunized with the outer membrane of B. fragilis strain 23745 were protected to a significant degree from abscesses caused by challenge with B. fragilis or B. distasonis. Such immunization had no overall effect on the development of abscesses in animals challenged with the entire cecal contents of meat-fed rats; however, B. fragilis was eliminated from the abscesses of these animals. Animals immunized with the capsular polysaccharide were protected from early B. fragilis bacteremia.
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PMID:Protective efficacy of immunization with capsular antigen against experimental infection with Bacteroides fragilis. 52 89

Organisms of the genus Bacteroides represent the major group of obligate anaerobes involved in human infections. Bacteroides usually cause either bacteremia or localized abscesses. Of the numerous species of Bacteroides, Bacteroides fragilis is the single most frequent clinical isolate. B. fragilis and Bacteroides melaninogenicus have chemically incomplete lipopolysaccharides as compared with the lipopolysaccharides (endotoxins) of aerobic bacteria, and the lipopolysaccharides of Bacteroides lack the biologic potency characteristic of endotoxin. This inactivity may account for the very infrequent occurrence of disseminated intravascular coagulation or purpura that can accompany sepsis due to these organisms. Furthermore, strains of B. fragilis have an immunologically common capsular polysaccharide. In an animal model of intraabdominal sepsis, the encapsulated strains caused abscesses when given without other organisms, but abscess formation from unencapsulated strains of Bacteroides generally required the administration of a synergistic aerobe. The abscesses caused by encapsulated strains were shown to be directly attributable to the capsular polysaccharide, which is an important virulence factor of this organism. Patients or experimental animals infected with B. fragilis develop antibodies to the capsular polysaccharide, and these antibodies can be detected in a radioactive antigen-binding assay.
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PMID:Surface antigens as virulence factors in infection with Bacteroides fragilis. 54 84

Campylobacter fetus is a fastidious, curved, Gram-negative bacillus that has been increasingly associated with human disease. To our knowledge, we are reporting the first documented case of C fetus sepsis associated with an aortic mycotic aneurysm. Typical of previously reported cases of infections caused by this organism, this case involved a debilitated patient who was seen initially with a subacute febrile illness associated with bacteremia, but who died suddenly when the unsuspected aneurysm ruptured. The isolate was presumptively identified by its growth characteristics, motility, curved shape, and the presence of a single polar flagellum.
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PMID:Campylobacter fetus sepsis with mycotic aortic aneurysm. 58 40

Pasteurella multocida has been the etiologic agent in at least three cases of "spontaneous" bacterial peritonitis (SBP). We report another patient with P. multocida bacteremia and SBP and suggest that there may be more than a chance association between cirrhotic liver disease and this unusual organism which rarely causes sepsis in man.
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PMID:Pasteurella multocida bacteremia associated with peritonitis and cirrhosis. 60 99

Bacterial sepsis, a major complication of chronic hemodialysis, is due mainly to infections of the vascular access site despite increasing use of internal fistulas. Sixty episodes of septicemia occurred in two chronic dialysis centers, with an incidence of 0.15 episodes of significant bacteremia per patient-dialysis-year in each. Forty-four of the 60 episodes were judged to be due to vascular access site infection by clinical, bacteriologic, and histologic criteria. Seventy percent (31 of 44) of the vascular access site-related episodes were due to staphylococci and 25% (11 of 44) to Gram-negative bacilli; nonvascular access site-related episodes were often due to transplant site infections caused by Gram-negative bacilli or streptococci. Mortality was about 18% in both vascular access site-related and nonrelated septic episodes. Bovine heterograft arteriovenous fistulas more often led to sepsis than did Brescia arteriovenous fistulas. Treatment with appropriate antibiotics was successful in most cases. Routine removal or ligation of the vascular access site was not necessary.
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PMID:Septicemia in patients on chronic hemodialysis. 61 55

PVE is increasingly frequent and often lethal. The classic features of infective endocarditis may be absent early in the course of the illess. Therefore, patients with prosthetic heart valves and fever must be considered candidates for this infection until another cause for the fever can be established. Five to six blood cultures will document the persistent bacteremia of PVE in most cases. Treatment consists of parenteral penicillins for sensitive organisms plus valvular re-replacement for intractable heart failure mechanical malfunction of the valve, persistent sepsis, or multiple major emboli. In spite of aggressive therapy, the mortality remains high. Therefore, appropriate prophylaxis is warranted in patients with prosthetic valves who must undergo procedures that might lead to bacteremia.
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PMID:Prosthetic valve endocarditis. 62 May 13

A 60-year-old man treated with a prothesis for aorto-enteric fistulae developed multicentric osteomyelitis. Enteric flora were cultured from blood and bone but the diagnosis was delayed. Aorto-enteric fistulae can occur in a variety of circumstances but have become more common with the advent of reconstructive vascular surgery using prostheses. This entity frequently does not present in a dramatic way, but can be the cause of fatal bacteremia and septicemia.
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PMID:Aorto-enteric fistula presenting as multicentric osteomyelitis. 65 31

To ascertain the significance of anaerobic bacteremia in a children's hospital, the records of all patients whose blood cultures grew anaerobes during a 24-month period were reviewed. Anaerobes were isolated from 144 out of 1,126 blood cultures yielding bacteria. Anaerobic diphtheroid grew in 122 out of 143 anaerobic cultures, but only 4 out of 122 were isolated from patients with anaerobic sepsis. Nine per cent of the total episodes of anaerobic bacteremia occurred in 13 children who met out criteria for anaerobic sepsis; two oor more blood cultures obtained within a three-day period growing anaerobic bacteria, or an aerobe and an anaerobe, in a febrile child or one with an apparent infectious focus. Bacteroides accounted for 7 out of 13 (64 per cent) of the relevant isolates, while anaerobic diphtheroids 4 out of 13 (26 per cent) and anaerobic gram-positive cocci accounted for the remainder 2 out of 13 (18 per cent). Only one infant, with polymicrobial bacteremia, died, suggesting that anaerobic bacteremia is associated with less mortality in children than in adults. Anaerobic sepsis occurred in children who have had recent abdominal surgery, or who are immunosuppressed.
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PMID:Anaerobic bacteremia as observed in a children's hospital. Clinically this may signify true anaerobic sepsis. 67 83

Vacuolization of the polymorphonuclear leukocyte (PMN) has generally been regarded as an indication of bacterial infection and has been particularly useful in diagnosing septicemia. In an effort to predict septicemia, peripheral blood smears from 69 febrile children were examined and systematically scored for severity of vacuolization. Thirteen children had remarkable vacuolization compared to the others. These 13 included only five children with bacterial illnesses and only one of the seven children with septicemia. Our finding that PMN vacuolization was neither diagnostic of septicemia nor predictive of bacterial infection suggests that the specificity of the link between vacuoles and bacteremia needs to be reassessed.
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PMID:Clinical usefulness of polymorphonuclear leukocyte vacuolization in predicting septicemia in febrile children. 68 85


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