Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The patterns of endogenous bacterial participation, particularly of Bacteroides fragilis, in the condition called progressive anaerobic syndrome and their clinical consequences are discussed. B. fragilis is an anaerobe recently resistant to tetracycline, which before 1970, was the drug of choice. Presently, clindamycin is the drug of choice for severe Bacteroides infections, though diarrheal side effects often interfere with administration; if contraindicated or side effects occur which are intolerable, doxycycline is indicated, for this -OH-substituted form rarely shares cross-resistances with other tetracyclines. A Bacteroides infection almost invariably involves organisms that have been present within the patient's own microbiologic environment, especially mucosal areas such as the female genital tract and the gastrointestinal tract. In the course of disease, whether spontaneous or due to iatrogenic factors, certain conditions are created that may select for the Bacteriodaceae by virtue of creating a low oxidation-reduction potential: 1) creation of new tissue spaces, i.e., hematomas; 2) necrotic tissues that might be present with incomplete abortion or retained products of conception, criminal abortion, degenerating tumor masses, crush injury, or devitalization of previously healthy tissue; 3) penetration of the gastrointestinal tract with spillage of fecal material; and 4) alteration of the microbiologic environment by Neisseria gonorrhoeae. Clinical consequences include the continuum of endometritis--septic thrombophlebitis--septicemia and puerperal septic abortion.
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PMID:Infectious morbidity due to Bacteroides fragilis in obstetric patients. 76 27

The role of Bacteroides fragilis in the etiology of gynecological infections is illustrated by a case history of a 49-year old woman. The patient was seen for removal of a Super-Dana IUD inserted 10 years prior to the present admission. Gynecological examination indicated enlargement of the uterus and myomatous nodule in the anterior wall. The patient underwent typical total hysterectomy with bilateral adnexectomy. Histological examination of the surgical specimen showed uterine leiomyoma, proliferative endometrium, and a focus of subserous hemorrhage. Postoperatively, the patient was given the antibiotic tetraolean (100 mg, 4 times/day, for 5 days). On day 8 after the surgery, the patient rapidly developed clinical manifestations of sepsis. Vaginal examination showed mild infiltration of the parametrium and greenish-bluish putrid exudate. With provisional diagnosis of anaerobic-aerobic infection, the patient was given combined antibiotics. Bacteriological culturing of a specimen from vaginal exudate indicated the presence of Bacteroides fragilis. The patient received antibacterial therapy for 10 days, and was discharged in good condition. These findings illustrate the possibility of development of postoperative Bacteroides infection in patients with inserted IUD.
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PMID:[Bacteroides fragilis in anaerobic infection with bacteremia following total hysterectomy]. 344 14