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

The patient was a 26-year-old man who complained of headache and vomiting. On examination, there was nothing abnormal, but the edge of the right optic papilla was not clear. His temperature was 38.5 degrees C, pulse 96/min, blood pressure 120/80 mmHg. A space-occupying lesion in his fronto-dextra cupular part was found by CT scanning. He had a 12-year history of chronic purulent otitis. The diagnosis was a brain abscess in the fronto-dextra cupular part. The brain abscess was extracted and Pasteurella multocida was isolated from the dark brown pus draining from the abscess. The patient recovered through proper antibiotic therapy based on a sensitivity test. Reports of infections caused by this organism in foreign countries very widely from local infections due to bites and scratches by cats, dogs etc. to general infections such as infections of the respiratory tract, sepsis and meningitis. However, Pasteurella multocida brain abscesses are rare. Pasteurella multocida is a Gram-negative short rod which is best known as part of the mouth flora and as a pathogen causing septicemia in many domestic animals, such as cats, dogs etc.. Infection in man results mainly from animal bites or scratches. It has been reported that Pasteurella multodida can cause human septicemia, meningitis, respiratory tract infection, conjunctivitis and other infections. We isolated a strain of Pasteurella multocida from the pus of a brain abscess following chronic purulent otitis on August 6, 1990.
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PMID:Brain abscess due to Pasteurella multocida. 817 82

We report three newborns with brain abscesses. Two infants suffered from Serratia marcescens meningitis and one infant had enterococcal sepsis and meningitis. Brain abscesses were detected by cerebral sonography. Outcome in one infant with S. marcescens infection was poor. This patient developed multicystic encephalo-malacia and severe developmental retardation. In the other patient with S. marcescens infection surgical drainage of the abscess was performed. The outcome was good both in this infant and in the patient with enterococcal brain abscess.
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PMID:Brain abscesses in neonates--report of three cases. 822 7

Ninety patients with esophageal perforations were operated on at our institutions between 1970 and 1992. Thirty-four of them were seen after delayed diagnosis (> 24 hours) with mediastinal sepsis caused by perforation of the thoracic esophagus. There were 18 patients with spontaneous ruptures, 11 with instrumental perforations (including one caused during laparotomy), and 3 perforations caused by foreign bodies. One patient had perforation of an esophageal ulcer into the pericardium and another had perforation of an esophageal diverticulum into the mediastinum. Nineteen patients underwent primary repair of the perforation with cleansing and drainage of the mediastinum and the pleural cavity. The remaining 15 had primary extirpation of the thoracic esophagus, irrigation of the mediastinum with antibiotics, cervical esophagostomy, gastrostomy, and drainage of the mediastinum and pleural cavity. Nineteen of the 34 patients survived (hospital mortality 44%). Of patients with primary repair, only six survived (in-hospital mortality 68%), whereas only two patients treated with esophagectomy died (in-hospital mortality 13%). The difference was highly significant (p = 0.001). The most common cause of death was multiorgan failure resulting from sepsis. Postoperative complications developed in four patients treated with primary repair (two sepsis, one empyema, and one anuria) and in seven patients treated with esophagectomy (two empyema, two sepsis, one pneumonia, one mediastinal abscess, and one brain abscess). After healing of the mediastinitis, the esophagogastric continuity was reconstructed with colon in 11 patients and stomach in two patients. In the management of delayed esophageal perforation with mediastinal sepsis, esophagectomy is superior to primary repair alone, which often leads to mediastinal leakage, continued sepsis, and death.
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PMID:Management of delayed esophageal perforation with mediastinal sepsis. Esophagectomy or primary repair? 804 Nov 95

A case of Fusobacterium necrophorum bacteremia and multiple brain abscesses in a 6-year-old child following a Mycoplasma pneumoniae infection is described. Brain abscess due to this microorganism has only been described in three other cases since 1977. The clinical picture was consistent with postanginal septicemia, with septic metastatic complications normally only seen in teenagers and young adults. The patient was successfully treated with a 2-month course of parenteral penicillin G and metronidazole.
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PMID:Multiple brain abscesses and bacteremia in a child due to Fusobacterium necrophorum. 836 15

In patients with septic shock and multiorgan failure including acute renal failure, the prognosis is poor. This study evaluated the effects of plasma exchange as adjunctive therapy to the conventional treatment in such severely ill patients and compared the results with the expected outcome according to data from other studies. A total of 25 patients (17 men and 8 women, mean age 47, range 15-74 years) were treated by a median of 3 (range 1-10) plasma exchanges, mainly by centrifugation technique. The main replacement fluid was liquid-stored plasma and albumin (in a few cases fresh frozen plasma). About 80% of the patients also received low doses of steroids (hydrocortisone 200-400 mg/day and heparin 1,000-25,000 U/day). Twenty of the patients survived (80%) which was significantly better than was expected by conventional treatment (< 20% survival, p < 0.001). The relative chance to survive was four times greater than expected. Five patients died. The reason of death was cerebral hemorrhagia, brain abscess, myocardial sudden death, relapsing sepsis from multiple hepatic abscesses, and a psoas abscess which was not drained. The patients who survived regained almost total renal function and could leave the hospital with only a few sequelae. The plasma exchange may be a good adjunct to conventional therapy to increase the chance of survival when other treatment is insufficient. The mechanisms by which plasma exchange acts may be by removal of endotoxins derived from microorganisms or tissue necrosis and removal of excessive amounts of cytokines together with a modification of various cascade systems enabled by the products in the plasma from the healthy donors, used for replacement.
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PMID:Plasma exchange in patients with septic shock including acute renal failure. 871 73

It is important that surgical treatment of infective endocarditis involves complete debridement of the affected tissue. In case of abscess formation in the mitral anulus and/or aortic root, disruption of the anulus occurs because of radical resection of the abscess. David et al. reported a new technique for mitral and aortic anulus reconstruction. The novel part of the technique was the endocardial repair, i.e., suturing of a pericardial patch to the endocardium of the left ventricle. We were surprised to learn that the left ventricular endocardium and muscle are capable of tolerating the stress induced by the prosthetic ring, especially in the mitral position. Since 1992, we treated eight cases of anulus disruption using this technique ; 5 cases involved the mitral anulus, 1 involved the aortic, and 2 involved both. We used a slightly different technique involving suturing of a patch not only to the left ventricular endocardium but also to left atrial wall for reinforcement. Two patients died in the perioperative period. One had a brain abscess ; the other had methicillin-resistant Staphylococcus aureus sepsis and mediastinitis. There was 1 late (sudden, unknown) death 3 years after the operation. No perivalvular leakage, dehiscence of the patch, hemolysis, prosthetic valve endocarditis, or thromboembolism have been observed in the other 5 patients.
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PMID:[Valve replacement concomitant with anulus reconstruction]. 874 30

Sixty-seven patients with brain abscess were managed over 19 years (1975-1993). Our series had a 2.5 to 1 male predominance; the age distribution was from 3 days to 81 years. The underlying conditions of hematogenic brain abscesses (n = 33; 49%) included lung infections (n = 16), heart disease (n = 4), sepsis (n = 10), and other foci (n = 3). Otolaryngologic infections led to the abscess in 10 cases; there were 9 traumatic abscesses. The causes remained unknown in 15 cases. There were 47 solitary abscesses (70%) and 20 multiple abscesses. The most frequent presenting signs and symptoms were neurologic deficits (n = 17), disturbances of consciousness (n = 14), seizures (n = 6), and headaches, meningism and vomiting (n = 13). Causative organisms were isolated in 39 cases (58%) and included staphylococci (n = 6), streptococci (n = 6), enterobacteriae (n = 2), and anaerobic pathogens (n = 9). The most reliable laboratory sign of inflammation was an elevated ESR (52/59 patients). With the advent of computed tomography, burr hole aspiration of the abscess with or without drainage was possible in 30 cases; the mortality in this subgroup was 9%. All 4 patients with surgical excision in the pre CT-era died. The mortality of patients treated with antibiotics only was 62% (18/29). Overall mortality was 37% (25/67), including 5 cases with post mortem-diagnosis of brain abscess. Good recovery was achieved in 29/42 survivors. Predictors of a poor outcome were the patient's age, the level of consciousness, multiple abscesses, polybacterial cultures, and a hematogenic etiology, but not the size of the abscess.
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PMID:[Bacterial brain abscess--experiences with 67 patients]. 880 80

Three patients presented with brain abscess associated with ventricular rupture. The origins of infection were sepsis, congenital heart disease, and unknown, and the organisms were Gram-negative cocci in one and Streptococcus species in two. Ventricular rupture occurred before administration of antibiotics and caused consciousness disturbance in all three patients. Continuous ventricle drainage was begun and antibiotics were directly administered into the ventricles. Aspiration and drainage from the abscess was also performed in two patients. Ventricular irrigation resulted in an excellent effect in one patient. The outcomes were excellent in two patients and fair in one. Aggressive ventricular drainage in the very early stage and direct intraventricular administration of antibiotics are very important to obtain a favorable outcome in patients with brain abscess and ventricular rupture.
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PMID:Treatment of brain abscess associated with ventricular rupture--three case reports. 930 Dec 2

Citrobacter sedlakii was isolated from blood and cerebrospinal fluid cultures of a 5-day-old premature infant with sepsis, meningitis, and brain abscess. This newly described organism was difficult to identify due to discrepancies between the Vitek and API 20E identification systems. To our knowledge, this is the first report of the isolation of C. sedlakii from cerebrospinal fluid.
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PMID:Citrobacter sedlakii meningitis and brain abscess in a premature infant. 931 37

Melioidosis is a tropical environmental hazard that causes acute and chronic pulmonary disease, abscesses of the skin and internal organs, meningitis, brain abscess and cerebritis, and acute fulminant rapidly fatal sepsis. It is more common among adults, individuals with diabetes, and individuals with chronic renal disease, but it can occur in normal hosts and children. Burkholderia pseudomellei is the most prevalent cause of community-acquired pneumonia, liver and splenic abscess, and sepsis in northeastern Thailand. Melioidosis can reactivate years after primary infection and result in chronic or acute life-threatening disease. With increasing worldwide travel and migration, patients may present in nonendemic countries with reactivation melioidosis decades after leaving an endemic region. We discuss seven selected patients presenting with this disease to a tertiary care facility in Bangkok between 1995 and 1997. Awareness should allow early diagnosis and treatment, which can lead to decreased morbidity and mortality.
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PMID:Melioidosis, an environmental and occupational hazard in Thailand. 1049 39


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