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

Three patients with clostridial sepsis during or following hepatic arterial infusions for the regional chemotherapy of hepatic metastatic tumors are described. In all patients abdominal roentgenograms revealed lucencies in the right upper quadrant consistent with gas-containing hepatic abscesses at the time of clinically apparent sepsis and positive blood cultures. The occurrence of three such cases in one year and the low incidence of clostridial infections in non-catheterized oncology patients at our institution suggest that clostridial infection is a previously unrecognized complication of hepatic arterial infusion chemotherapy. The possible sources of the infecting organisms and pathogenesis of this infection are discussed.
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PMID:Clostridial sepsis following hepatic arterial infusion chemotherapy. 49 40

After a criminal abortion, a 21-year-old woman developed clostridial sepsis, massive hemolysis, shock, and protracted renal failure. Anuria was present for 3 weeks and hemodialysis was required for 35 days. Because of the prolonged anuria, the patient was thought to have irreversible renal cortical necrosis. A renal biopsy demonstrated tubular necrosis only. Shortly after the biopsy procedure, urinary volumes began to increase, and renal function gradually returned to normal levels. This case demonstrates that a protracted course of renal failure following clostridial infection is not necessarily due to cortical necrosis but may result from tubular necrosis, and renal function may return to normal.
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PMID:Recovery after prolonged anuria following septic abortion. 124 89

The authors describe a sixty-seven-year-old hypertensive, diabetic man with a mycotic abdominal aortic aneurysm infected with Clostridium septicum. The patient had colonic polyps but no malignant disease. They could find only one other report of a mycotic aneurysm infected with C. septicum. In that case, as in most other cases of C. septicum bacteremia, the patient had gastrointestinal cancer. Their case suggests that treatment for a clostridial infection should be considered in patients with known gastrointestinal disease, signs and symptoms of sepsis, and abdominal pain. Conversely, patients known to have a C. septicum infection should be evaluated for gastrointestinal lesions.
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PMID:Mycotic aortic aneurysm infected by Clostridium septicum--a case history. 186 18

We report 2 patients with myonecrosis due to Clostridium septicum and associated colon carcinoma and have reviewed the English language literature for all reported cases of atraumatic C. septicum infection. A total of 162 cases of C. septicum infection have been reported. Eighty-one percent of these patients had an associated malignancy. Thirty-four percent of all patients had associated colon carcinoma, while 40% had a hematologic malignancy. Thirty-seven percent of reported patients had an occult malignancy at the time of their infection with C. septicum. In many patients, the portal of entry was found in the large intestine. In a particularly lethal form (79% mortality) of C. septicum infection, known as "distant myonecrosis," infection metastatic from the initial site of infection causes severe myonecrosis, gangrene, and often death within hours of clinical detection. Overall, survival of patients with C. septicum infection is only 35%. Review of all cases of C. septicum infection suggests several conclusions. 1) Patients with malignancy, particularly colonic or hematologic, and patients with cyclic neutropenia who develop signs and symptoms of sepsis, especially with associated findings of abdominal pain or pain in an extremity, should be treated for possible clostridial infection. 2) C. septicum infection does not appear to be a result of a single specific defect in either humoral or cell-mediated immunity. Rather, it may occur in patients who are granulocytopenic and therefore prone to an enterocolitis. 3) Patients in whom an infection with C. septicum is found must undergo a vigorous search for malignancy following acute therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Clostridium septicum infection and associated malignancy. Report of 2 cases and review of the literature. 264 85

A 38-year-old woman with chronic, noncyclic neutropenia had an episode of acute abdominal pain associated with clostridial septicemia. Clostridium paraputrificum was isolated from blood and peritoneal cultures. The pathogenic potential of C paraputrificum was established by surgical biopsy specimens which demonstrated necrotizing enterocolitis with the typical gram-positive rods. This report strengthens a recognized, established association between neutropenia and clostridial infection.
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PMID:Necrotizing enterocolitis associated with Clostridium paraputrificum septicemia. 334 Aug 84

A neutropenic patient with leukemia treated successfully several times for infectious complications died suddenly after developing widespread gas formation in many tissues due to C septicum sepsis. Localized severe pain in a susceptible patient with few other signs or symptoms should alert the practitioner to the possibility of clostridial infection.
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PMID:Spontaneous clostridial sepsis and sudden death. 695 May 25

We describe the clinical course of a 58-year-old man who died from acute papillary muscle rupture as a complication of clostridial sepsis. There was no evidence for myocardial infarction, infective endocarditis, prior chest trauma or other known causes of papillary muscle rupture. Histological specimens taken at autopsy demonstrated clostridial infection of the heart. To our knowledge the occurrence of papillary muscle rupture in the setting of clostridial sepsis has not yet been reported in the literature.
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PMID:Acute papillary muscle rupture in a patient with clostridial sepsis. 910 40

Etiological factors promoting anaerobic non-clostridial infection (ANI) after appendectomy are analyzed for the last 10 years (1993-2002). Acute appendicitis was the indication for appendectomies in 2846 patients. In 55 (1.9%) patients ANI was detected 2-7 days after surgery. Later than 24 hours since beginning of the disease 40 (72.7%) patients were hospitalized. Diagnosis of ANI was based on typical clinical symptoms confirmed with bacteriological and morphological examinations. Treatment of ANI was complex: early radical surgery, massive antibiotic therapy, hyperbaric oxygenation, intensive care. 10-14 days after the last necrectomy (wound area from 139 to 1812 cm(2)) repair dermal-plastic surgeries were performed in 48 (87.3%) patients with good functional and cosmetic results. Two (3.6%) patients with ANI died. Of six patients with general forms of ANI admitted from other hospitals 3 patients died. Sepsis was the main cause of death. Late surgeries in general forms of ANI lead to worse results.
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PMID:[Anaerobic non-clostridial infection in acute appendicitis]. 1547 12

Necrotizing fasciitis is an uncommon but life-threatening condition with a high associated mortality and morbidity. Most infections are polymicrobial, another distinct form of necrotizing fasciitis that occurred by penetrating freshwater trauma, such as fishing or wading in wet fields. Aeromonas species are responsible. The rapidity of the infectious process is similar to that of clostridial infection, but gas production is not a consistent feature. We report a patient who presented with fever, chills, and bullae on left forearm, despite antibiotics and wound debridement; the infection extend to mid humerus with a rapid onset of skin necrosis and progressive sepsis. Aeromonas schubertii fasciitis is particularly virulent. An apparent superficial cellulitis that fails to respond to standard therapy must raise suspicion of a more extensive underlying subcutaneous infection. Aggressive surgical debridement and antibiotic coverage for gram-negative rods are the essential features of treatment. Delay caused by a mistaken diagnosis of cellulitis and subsequent inadequate debridement would likely prove fatal.
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PMID:A fatal case of necrotizing Aeromonas schubertii fasciitis after penetrating injury. 2124 22

Background. Clostridial infection following pregnancy may be fatal, and surgery is considered as the treatment of choice. We suggest a conservative management in selected cases when preservation of fertility is of major importance. Case. A 41-year-old primigravida presented with abdominal pain and fever, one day following dilatation and curettage at 20 weeks of gestation. Her abdomen was diffusely tender, with a uterus enlarged to 20 weeks' gestation. Laboratory studies were consistent with sepsis and hemolysis. CT demonstrated a gas-containing mass compressing the uterine cavity, and presence of air in pelvic veins. Blood cultures were positive for Clostridium perfringens. The patient was treated conservatively, with IV antibiotics and fluid resuscitation, and recovered. Conclusion. In selected cases of infected myoma complicated by clostridial sepsis, refraining from surgical intervention is a possible therapeutic approach.
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PMID:Severe Clostridial Pyomyoma following an Abortion Does Not Always Require Surgical Intervention. 2256 5


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