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)

We report results from 108 consecutive patients followed up for one year after chymopapain injection. The patients were selected on strict clinical and radiological criteria. In nine patients (8%) the result was poor, and they were surgically treated within one year after the injection. 99 (92%) patients improved and after one year 87 of these (81% of the total material) had returned full time to their previous occupation. The only serious complication was one case of septicemia and possible discitis. The patient made a full recovery after antibiotic treatment. On the basis of these results, we shall continue to use chymopapain injection to treat selected patients with sciatica caused by herniated lumbar discs.
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PMID:[Lumbar disk prolapse treated with chymopapain]. 141 32

We determined the incidence of acute, major complications in a population of 28,395 patients who underwent lumbar laminectomy for discogenic radiculopathy in the United States in 1980. This population was drawn from a broad cross-section of community hospitals and represented 31% of all patients who underwent laminectomy that year for this condition. Our cohort excluded patients with a) operations exceeding two disc levels, b) fusion, c) previous lumbar laminectomy, or d) coexistent discitis, spondylosis, spinal stenosis, myelopathy, or arachnoiditis. The incidence of death was 5.9 per 10,000. The causes of death were septicemia, myocardial infarction, and pulmonary emobolus. The incidence of at least one major complication was 157 per 10,000. The incidences of specific complications were as follows: infection requiring intravenously administered antibiotics, 30.7; major neurological deficit, 29.8; pulmonary embolus, 10.7; and myocardial infarction, 5.6. We studied four additional categories of complication. Patients were counted only when a second operation was required to treat the complication. The categories and incidence per 10,000 were as follows: incisional hematoma, 8.7; cerebrospinal fluid fistula, 10.5; ventral perforation, 1.6; and retention of a foreign body, 0.7. Among the patients whose hospitalizations were otherwise normal, 6.7% received a blood transfusion; of the patients whose hospitalizations were complicated, 24% required transfusion. The demographic characteristics of transfusion. The demographic characteristics of patients with a normal hospitalization were tabulated separately from those whose hospitalizations were complicated. Neurosurgeons performed 60% of the operations, and orthopedic surgeons performed 40%. The speciality of the surgeon was not a factor in determining the risk involved in surgery. Spinal anesthesia was used in 7% of the cases, and no pattern of complications emerged that was uniquely related to that technique.
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PMID:Complications and demographic characteristics of patients undergoing lumbar discectomy in community hospitals. 277 Sep 87

Discitis is a rare complication of disc operation. The incidence rate varies from 0.2 to 0.8% according to the series. During a 6 year period (1980-1986) 1,796 patients were operated for lumbar disc protrusion at our institution and twelve of them (0.66%) developed a post operative discitis. Bacteriologic verification due to the infection was ascertained in ten cases. Direct contamination during surgical time is likely far more frequent than hematogenous contamination because the liable germ was staphylococcus in 9 cases. Ascertaining the diagnosis is base upon clinical picture and some selected investigations. It may be earlier than it has been said before. Discitis may be suspected within a week after operation in two cases out of three. The most prominent clinical feature is back pain with muscle spasm but sometimes diagnosis may be misled to a psychiatric condition or a visceral disorder. Among conclusive investigations we range in the first place the needle aspiration of the disc which permitted to isolate a germ nine times out of eleven. Next the bone scan with H.M.D.P. Te 99 (8 Mbq/kg) which revealed a significant uptake pattern in eight cases out of eight. Finally the blood culture which grew five times out of ten. Risks of discitis, i.e septicemia, polysegmental infection or death justify in our opinion an appropriate antibiotherapy during at least 8 weeks. Moreover, in our experience, it is the best antalgic treatment that we can offer and back pain decreases as soon as the second day with antibiotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Spondylodiscitis after surgery of lumbar disk hernia. Apropos of 12 cases in 1796 operations]. 307 Apr 22

The authors report their experience of 12 discitis occurring in the new born and in young children. Pyogenic infections were found with general septicemia in the new born children. The onset of cases of Pott's disease occurred later. Anterior destruction of several vertebrae accounted for severe kyphosis which were found on clinical examination. Conservative immobilisation of the kyphosis during growth does not prevent any increase in deformity before puberty with the possible onset of neurological symptoms. The only possible treatment is surgical with anterior arthrodesis of the damaged region together with a corrective osteotomy followed as soon as possible by posterior arthrodesis. If, unfortunately the patient is seen later in the course of the disease, the possibility of corrective osteotomy will depend on the degree of kyphosis and the neurological symptoms.
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PMID:[Kyphosis caused by severe spondylodiscitis in newborn infants and young children]. 623 96

The ESR, a sensitive measure of the inflammatory response, is elevated in 90% of patients who have serious orthopedic infections, e.g., discitis, septic arthritis, and hematogenous osteomyelitis. In most cases, it is sufficient to distinguish these entities from the less serious disease states, i.e., transient synovitis. After major surgical operations or extensive trauma, the ESR often increases to high levels and, if sepsis does not supervene, it returns to normal within six months. Outpatient determination of the ESR, although useless in the early detection of malignancy, is valuable in detecting inflammatory arthridities and major sepsis.
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PMID:The erythrocyte sedimentation rate in orthopaedic patients. 704 36

In 29 children wih symptoms and signs as well as laboratory and radiographic findings consistent with intervertebral discitis, the syndrome appeared to be a manifestation of both infectious and noninfectious inflammatory processes. When systemic sepsis is present, antibiotic therapy is indicated. In the absence of fever and leukocytosis, plaster cast immobilization should suffice. Craig needle aspiration and/or open biopsy are not routinely required, but should be reserved for those patients who fail to respond to routine treatment in whom tuberculosis is suspected.
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PMID:Intervertebral discitis in children and adolescents. 706 29

A study of 30 patients admitted for infectious discitis identified four cases with concomitant bacterial endocarditis. All four patients were male and had concomitant streptococcal septicemia. Two patients had known aortic valve disease. The vertebral infection was located to the thoracic or lumbar spine. Ultrasonography disclosed aortic lesions in all four patients and mitral lesions in two. Management consisted of intravenous antimicrobial therapy for four weeks followed by a three-month course of oral antimicrobial therapy. The outcome of the discitis was favorable within the usual period of time. However, the endocardial lesions continued to progress, and three patients rapidly required valve replacement. Analysis of available data in the 30 patients with discitis showed that half the patients with streptococcal discitis also had bacterial endocarditis and that the latter condition developed in all the patients with streptococcal discitis and a history of valve disease. A number of risk factors were identified. An echocardiogram should be done routinely in patients with infectious discitis and risk factors for bacterial endocarditis.
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PMID:Bacterial endocarditis revealed by infectious discitis. 893 77

Clinical and laboratory findings in 120 patients with suspected discitis (loss of disk height and erosions of the vertebral endplates on plain radiographs) were reviewed and compared with percutaneous discovertebral biopsy results. Patients were categorized into three groups based on whether the symptoms developed after an invasive procedure (Group I), during septicemia (Group II), or spontaneously (Group III). Group II patients were more likely to have fever and had higher mean erythrocyte sedimentation rate and C-reactive protein values. A pathogen was recovered in the biopsy specimen in 34%, 60.7%, and 43.5% of patients in groups I, II, and III, respectively. Specific histologic changes were seen in 49%, 42.8%, and 51.3% of cases, respectively. The combination of clinical, laboratory test, and biopsy findings established the diagnosis of pyogenic discitis in 74 cases (62.5%), tuberculous discitis in nine cases (7.5%), and degenerative pseudodiscitis in 37 cases (30%). Percutaneous biopsy had a sensitivity of 72% and a specificity of 94%. Percutaneous discovertebral biopsy is helpful for the diagnosis of infectious discitis and should be done whenever this condition is suspected.
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PMID:Infectious discitis diagnostic contribution of laboratory tests and percutaneous discovertebral biopsy. 906 6

This report concerns a 66-year-old man suffering from prevertebral abscesses with a protracted insidious clinical course and subsequent lethal and acute pyogenic meningitis. The patient had a three-month history of mild neck pain, and died as a result of septic shock due to staphylococcus aureus (methicillin susceptible) infection two days after admission to the hospital. At autopsy, abscesses encapsulated by fibrous connective tissue were found on the ventral surfaces of the cervical and thoracic regions of the spine. The prevertebral abscess on the upper cervical region was organized with dense fibrous tissue and contained a small number of inflammatory cells. On the other hand, the prevertebral abscess on the thoracic region was purulent and contained numerous inflammatory cells, macrophages and gram-positive cocci. Pyogenic spondylitis and discitis accompanying the prevertebral abscesses were multiple and widespread. These features suggested that the abscesses developed initially on the cervical region, extended caudally through the prevertebral space, directly involving the corpus vertebrae and discs, and ultimately caused sepsis. It is important to note that prevertebral abscesses can exhibit a protracted clinical course with only mild symptom such as minor neck pain and then manifest abruptly as acute meningitis and sepsis.
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PMID:[Prevertebral abscesses with a protracted insidious clinical course and subsequent lethal, acute pyogenic meningitis and septic shock]. 949 3

The aim of the study was to present the intervertebral discitis of L5-S1 region and adjoining vertebrae in the course of staphylococcal sepsis. A 51-year-old man was treated in hospital because of sudden very strong pain in a lumbar-sacral region of spine with irradiation towards both legs. The patient had general symptoms of infection. The diagnosis of intervertebral discitis of L5-S1 region was made on the basis of magnetic resonance imaging and computed tomography. In case of radicular symptoms accompanied by very strong back pain, intervertebral discitis should be considered during diagnostic investigation.
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PMID:[Intervertebral discitis caused by staphylococcal sepsis]. 1110 8


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