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

Out of 38 leukaemic cases only 16 had extensive leukaemic infiltration at death. 15 patients had slight or moderate and 7 no infiltration at all. 12 of the 15, and 5 of the 7 died with septicaemia. The latter patients must have died of complications rather than of the leukaemia itself. Although it has been possible to reduce the incidence of septicaemia during life, terminal septicaemia does not yet seem to be preventable. Septicaemia was revealed at autopsy in 27 of 38 patients; 25 of these also had clinical signs of septicaemia before death. Necrotizing gastrointestinal lesions may cause endogenous infection. In the present material, almost every second patient had fungal septicaemia. Out of 7 patients having oral candidiasis in vivo 5 had systemic candidiasis at autopsy, but only half of the patients with systemic candidiasis had visible oral growth. Modern treatment of leukaemia seems to be able to prevent intracranial haemorrhage in 90% of the cases. On the other hand, vacuolization of muscle and liver tissue was a frequent finding in leukaemia. It is suggested as being caused by fatty degeneration. Vacuolization of myocardial cells was found in 7 out of 13 cases. Among these 7, 4 had had intermittent hypokalaemia.
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PMID:Autopsy findings in leukaemia. 99 42

Among leukemia patients, a significant number of deaths are due to Candida septicemia, many of which are associated with previous oral infections. Oral candidiasis detection methods vary, and the relationship between oral candidiasis and Candida colonization (CC) is not well defined. The main objectives of this study were to compare the incidence of CC in a healthy and leukemic population, and also to evaluate the efficacy of three simple and inexpensive methods of detecting oral CC in predicting the occurrence of oral candidiasis. A secondary objective was to portray speciation in the examined populations. Forty-two pediatric leukemia patients and 42 healthy, age-, race-, and gender-matched control patients participated in this study. The three methods of detection were cytological examination of the oral mucosa, and direct culture methods from mucosal smears using Sabouraud's dextrose agar (Becton Dickinson Microbiology Systems, Cockeysville, MD) and Oricult-N (Orion Diagnostica, Espoo, Finland). This study demonstrated an increased prevalence of CC in pediatric leukemia patients with the direct culture method detecting CC in a significantly greater proportion of the population (Oricult-N,P = 0.034; Sabouraud's dextrose agar, P = 0.0036). Candida albicans was the predominant species. Further study is needed to determine the clinical significance of oral CC and its relationship to oral candidiasis and systemic infection in pediatric leukemia patients.
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PMID:The detection of oral Candida in pediatric leukemia patients. 130 22

A prospective case series study was conducted Jan 1991-Oct 1991 on 108 neonates admitted to NICU, Lusaka. 90 patients satisfied inclusion criteria, 45 cases and 45 controls. Symptomatic seropositive babies born to seropositive mothers presented with failure to thrive, fever, persistent or recurrent thrush, severe Sepsis and large liver. Tendency to prematurity among cases was high. Diarrhoea, Sepsis and Haemolytic Anaemia appear to be terminal signs. Neonates suffer the most aggressive form of HIV/AIDS, with symptomatic cases dying 3-4/52 of onset of symptoms. Over one quarter of the mothers were symptomatic. Congenital malformations and Lymphadenopathy were not significantly associated. Microcephaly occurred in association with failure to thrive and was not an isolated finding.
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PMID:Clinical presentation of HIV/AIDS in the high risk neonate in Zambia. 139 42

The neonatal morbidity was studied in 7015 neonates born at the All India Institute of Medical Sciences Hospital, New Delhi. The incidence of low birth weight babies was 26.7 per cent; one seventh (13.5%) of the series were preterm (less than 37 wk), while 6.6 per cent were 'small-for-dates'. Birth asphyxia of varying severity developed in 5.9 per cent infants. Respiratory distress syndrome was diagnosed in 5.7 per 100 live-births; most being due to hyaline membrane disease (33.5%), which affected 14.1 per cent of preterm babies. Neonatal hyperbilirubinemia occurred in 5.9 per cent, most of whom were premature. In nearly one-fifth, the cause of jaundice could not be identified after detailed investigations. Minor bacterial infections (conjunctivitis, pyoderma, oral thrush, umbilical sepsis) were observed in 1.8 per cent while major infections (septicemia, meningitis, diarrhoea) in 3.0 per cent. The overall incidence of major malformations was 2.3 per cent. Reasons for low incidence of bacterial infections and common occurrence of hyaline membrane disease in premature infants, are highlighted.
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PMID:A four year study on neonatal morbidity in a New Delhi hospital. 193

Chlorhexidine's structural characteristics give it potent antimicrobial activity, effectiveness at low concentrations, substantivity that prolongs its therapeutic effect in the oral environment, minimal resorption from the gastrointestinal tract, and the ability to reduce plaque. The use of this agent for oral stomatitis in neoplasia patients has recently been studied. Treatment-associated oral soft tissue inflammation and ulceration were significantly reduced by chlorhexidine in patients undergoing intensive chemotherapy. Reductions in total streptococci and yeast counts were also observed. When used in conjunction with systemic antifungal agents, such as nystatin or clotrimazole, a significantly decreased incidence of clinical oral candidiasis and Candida septicemia was observed. In contrast, in two studies in which high-dose head and neck radiation therapy was applied, there was no reduction in stomatitis. Oral gram-negative bacilli have been shown to increase in high-dose chemotherapy patients who are taking chlorhexidine during the treatment period (3 wk to 2 mo). However, no increase in systemic gram-negative infections or other adverse negative medical consequences were observed. This agent appears to be of therapeutic benefit in reduction of dental plaque, gingivitis, and stomatitis in the high-risk chemotherapy population when used in conjunction with other topical and systemic antimicrobial agents as prophylaxis. Although no toxic or serious adverse effects of chlorhexidine rinse have been observed in the short-term studies to date, the effects of longer-term chlorhexidine administration should be evaluated.
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PMID:Oral antimicrobial agents--chlorhexidine. 218 58

This review describes the transmission, clinical picture and immunological abnormalities of HIV infection in children in general, and the special problems of AIDS in African children. The review begins with a thorough introduction to the epidemiology of AIDS. Transmission to children generally involves vertical transmission by placental transfer or transmission of HIV via transfusion of blood and blood products, or by contaminated needles. Casual transfer is unknown, and only a few cases of transmission via breast milk are known. The clinical picture of HIV infection in infants and children differs from that in adults in 3 important aspects: earlier onset, different clinical presentation and existence of AIDS embryopathy. The average onset was 5 months of age. The most common symptoms in young children are chronic interstitial pneumonitis without demonstrable etiology, hepatomegaly, failure to thrive, adenopathy, diarrhea, oral or perineal thrush, eczema and thrombocytopenia. The common opportunistic infections are pneumocystis carinii pneumonia, cytomegalovirus, Epstein-Barr virus, Cryptosporidium diarrhea, pyogenic infections of the middle ear and gram-negative septicemia. Several infections seen in adult AIDS cases are rare in children: mycobacterium avium-intracellulare, toxoplasma gondii, hepatitis B, as well as Kaposi's sarcoma, malignant lymphoma and cardiac abnormalities. The AIDS embryopathy or HIV dysmorphic syndrome is characterized by immunological abnormalities, growth failure, and craniofacial dysmorphism, particularly microcephaly, prominent box-like forehead, hypertelorism, flattened nasal bridge, obliquity of the eyes, blue sclerae and patulous lips. AIDS in African children is extremely difficult to diagnose because of similarities between the presenting symptoms and those commonly seen in sick children there, many of whom are also immune compromised. Where serotesting is available, the picture is complicated by cross reaction between the test agents and some factor found in sera from malaria patients. Seropositivity in some areas is high, increased by the prevalence of transfusion and injection treatments. Diagnosis is made more difficult by lack of laboratory facilities and difficulties in follow-up for pediatric patients. The CDC definitions of AIDS and ARC, and the WHO/CDC definitions of AIDS are appended.
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PMID:Human immunodeficiency virus infection in childhood. 245 15

Fluconazole, a triazole antifungal agent newly developed by Pfizer Inc.. was given orally to 4 patients with deep mycosis. Fluconazole was markedly effective against septicemia due to Candida and oral candidiasis accompanied with lingual ulcer in spite of seriousness of these underlying disease. In 2 patients with aspergilloma, eradication or contraction of fungus ball was observed and the drug was judged to be effective. In vitro MICs of fluconazole against clinically isolated Aspergillus spp. were much higher than its serum levels leaving a large discrepancy between in vitro activity and clinical efficacy. Although the dosage was 100-300 mg daily for 8 days to 6 months, neither adverse reactions nor laboratory parameter abnormalities were observed. The above results suggest that fluconazole is a useful agent in the treatment of fungal infections.
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PMID:[Clinical evaluation of fluconazole in patients with mycotic infection]. 254 Mar 61

1. Cefmenoxime (CMX) was administered with a dosage regimen of 20-25 mg/kg, 2-3 times daily (40-75 mg/kg/day) by intravenous drip over 30 minutes to 9 neonates with bacterial infections including purulent meningitis and septicemia. Clinical responses to the treatment were excellent in 7 and poor in 2. Bacteriological responses were "eradication of pathogens" from 8 of them except another patient with an infection due to Staphylococcus aureus. 2. Adverse reactions to CMX were observed in 6 of 18 neonates treated with the drug: diarrhea, oral thrush, and the elevation of S-GOT, S-GPT, LDH and alkaline phosphatase. None of the reactions, however, necessitated the discontinuation of the treatment. 3. Changes in blood concentrations of CMX in neonates with ages between 0 and 30 days were followed. These subjects included 16 mature neonates and 10 neonates with low birth weights. Intravenous drip infusion of 20 mg/kg of CMX over 30 minutes was immediately followed by peak blood CMX concentrations of 34.6-72.7 mcg/ml (mean +/- S.D.: 50.4 +/- 11.3 mcg/ml) in the mature neonates, and 22.3-78.2 mcg/ml (55.5 +/- 16.5 mcg/ml) in the neonates with low birth weight. Blood half-lives of the drug in the mature neonates were in the range from 1.7 to 20.7 hours (5.9 +/- 6.6 hours) in subjects with ages of 0-3 days, and 1.1-3.5 hours (2.0 +/- 0.8 hours) in subjects of 4-25 days. In neonates with low birth weight, they were 3.4-10.2 hours (7.2 +/- 2.7 hours) in subjects of 0-2 days, and 1.4-5.5 hours (3.0 +/- 1.5 hours) in subjects of 4-30 days. In other words, the blood half-lives of the drug tended to be longer in younger subjects. 4. Concentration of CMX in cerebrospinal fluid (CSF) were determined in a patient in acute stage with purulent meningitis caused by Mycoplasma hominis. Intravenous drip infusion of 80 mg/kg of CMX over 30 minutes was followed by CSF concentrations of 7.7-15.5 mcg/ml. 5. MICs of CMX for clinical isolates were determined. The drug was proved to have excellent antibacterial activities against Escherichia coli (3 strains) and group B hemolytic streptococci (2 strains) and these MICs were comparable to those of cefotaxime. The MIC of CMX for S. aureus (1 strain) was high at 25 mcg/ml with an inoculum size of 10(8) CFU/ml. This MIC value of CMX was higher than that of cefmetazole.
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PMID:[A preclinical and clinical study of cefmenoxime in newborns]. 261 17

Deep mycoses present new aspects characterized by deep, visceral mycotic localisations and septicemia, particularly in immunocompromised conditions. In immunodepressed patients (leukaemia, transplantation), the granulopenia descending to 500 elements/ml leads not only to invasive aspergillosis and candidosis but also to infections due to opportunistic fungi exceptionally or never seen formerly. AIDS favours opportunistic fungi related to defective cellular immunity as Cryptococcus neoformans, responsible of severe meningoencephalitis and septicemia, as Candida albicans responsible of thrush and oesophagitis, but also true pathogenic fungi (Histoplasma capsulatum) becoming opportunistic in such conditions. C. albicans provokes in heroin addicts a new septicemic syndrome with cutaneous, ocular and osteoarticular lesions and in leukaemic patients hepatic micro-abscesses soon after the neutropenic phase induced by chemotherapy. New methods for immunologic diagnosis (research of circulating fungal antigen), for clinical diagnosis (scanning, magnetic resonance). New strategy of antifungal chemotherapy (itraconazole, fluconazole) allow to a better knowledge and control of this new infectious pathology.
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PMID:[Current role of deep mycoses in infectious pathology]. 281 46

Six Caribbean patients with histologically and immunologically characterized adult T-cell leukemia/lymphoma (ATL) were treated intravenously (IV) with 2'-deoxycoformycin (DCF) at a dose of 5 mg/m2 on days 1, 2, 8, 15, and 22 with four additional weekly doses to convert any partial responses (PR) to complete responses (CR). Patients were considered eligible for this study if refractory to or relapsed from combination chemotherapy, had a life expectancy of 4 weeks or more, a performance status greater than or equal to 50%, normal renal and hepatic function, and no chemotherapy within 4 weeks. Clinical characteristics of the patients in this study included lymphadenopathy in five patients, skin involvement in four patients, bone marrow infiltration in five patients, and central nervous system involvement in two patients. Circulating ATL cells were present in four patients, and three were hypercalcemic. Of five patients evaluable for response, there was one PR of 1 month, and two minor responses lasting 2 and 3 weeks. The median duration of survival for all treated patients was 3 weeks or more. The DCF was associated with moderate side effects, including conjunctivitis in three patients, nausea and vomiting in two patients, progressive hepatic insufficiency in one patient, and moderate myelotoxicity in three patients. Infections occurred in four patients, including two cases of oral candidiasis and two cases of fatal neutropenic sepsis in patients receiving concurrent intrathecal methotrexate. As a single agent, DCF appears to have limited activity in advanced refractory/relapsed ATL. Studies in the future should explore DCF in combination with other cytotoxic agents as initial therapy in better-risk patients.
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PMID:2'-Deoxycoformycin therapy in adult T-cell leukemia/lymphoma. 289 Apr 28


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