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

Ecthyma gangrenosum has not been described during the course of blood stream invasion with Pseudomonas maltophilia, although it occurs with a 30% frequency in Pseudomonas aeruginosa septicemia. We isolated P. maltophilia from the blood and an ecthyma lesion in a leukemic patient. The organism was an avid protease and elastase producer and hence mimicked the exoenzyme profile of invasive P. aeruginosa. The patient responded to moxalactam to which the isolate was susceptible in vitro. On the basis of this report, P. maltophilia may be included among an emerging number of gram-negative bacillary species capable of producing severe cutaneous manifestations of bacteremia.
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PMID:Pseudomonas maltophilia exoenzyme activity as correlate in pathogenesis of ecthyma gangrenosum. 353 6

Bacteremia caused by Aeromonas species occurred in 24 hospitalized patients in a cancer institute during a 13-year period. All but one of these patients had a malignancy (88% had leukemia), and most were receiving chemotherapy for cancer. There was a striking numerical predominance of male patients (82%). Unlike some previously described patients with infections due to this organism, none of these 24 patients had recently been exposed to fresh or salt water or to fish. The source of the infecting organism was thought to be endogenous--i.e., from patients' own gastrointestinal tracts. The clinical presentation of sepsis caused by this organism was nonspecific, except that ecthyma gangrenosum occurred in several patients. The overall mortality rate was 28%. The combination of an aminoglycoside and a cephalosporin is appropriate therapy for bacteremia caused by Aeromonas species.
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PMID:Bacteremia caused by Aeromonas species in hospitalized cancer patients. 402 26

A simple, reproducible model of fatal Pseudomonas aeruginosa sepsis in mice during immunosuppression was developed. Mice were rendered leukopenic (less than or equal to 800 leukocytes per mm3 of blood) for a period of 5 days by multiple injections of cyclophosphamide. Mice were challenged at the onset of leukopenia by instilling the bacteria onto a 0.5-mm incision made into the back. The mean lethal dose (LD50) for P. aeruginosa PA220 and M-2 was less than 20 bacteria. The mean time to death for these strains ranged from 46 to 59 h. Leukopenic mice were comparatively resistant when challenged with Klebsiella pneumoniae (LD50 = 1.5 x 10(6)) or Staphylococcus aureus (LD50 greater than 10(6)). Infection with P. aeruginosa was characterized by rapid bacterial multiplication in the skin at the site of infection, producing ecthyma gangrenosum. Bacteremia and colonization of the liver were pronounced 21 h postinfection. This model should prove to be a useful tool for studying the pathogenesis of P. aeruginosa infections under immunosuppressed conditions.
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PMID:Simple model for the study of Pseudomonas aeruginosa infections in leukopenic mice. 640 16

Experimental and clinical studies were conducted on a new synthetic cephalosporin antibiotic cefoperazone (CPZ). Antibacterial activity of CPZ against S. aureus, E. coli, Klebsiella sp., Proteus sp. and P. aeruginosa was compared with that of cefazolin (CEZ), cephalothin (CET), gentamicin (GM) and cefotaxime (CTX). Ordinary cephalosporin C antibiotics, CEZ and CET showed an excellent antibacterial activity against S. aureus, while CPZ showed a low MIC of 3.13 mcg/ml even 10(6)/ml inoculation. CPZ showed an antibacterial activity against Gram-negative bacteria such as E. coli, Klebsiella sp. and Proteus sp. Its activity was very similar to CTX and superior to CET and CEZ. CPZ showed the greatest activity against P. aeruginosa, i.e., 2 tubes greater than CTX. By intravenous injection, the peak of blood concentration of CPZ treated with 25 mg/kg was 42 mcg/ml (4 cases); in the case of 1 hr. drip infusion, the peak of blood concentration with same dose was 41.25 mcg/ml at the end of drip infusion. By both routes of administration, the half lives were noted to be as long as 101.4 and 84.8 minutes, respectively. The recovery rates (3 cases) in the urine were quite different: 60.8%, 22.6% and 76.8% at 6 hours after administration. The spinal fluid concentration of CPZ was about 5 mcg/ml in the acute stage during the first 5 days and the CSF/serum ratio was above 10%. Clinical evaluation of CPZ was performed in a total of 31 cases; 13 cases of respiratory tract infection, 8 cases of urinary tract infection, 2 cases of staphylococcal scalded skin syndrome, 2 cases of enterocolitis, 2 cases of septicemia and 4 cases of purulent meningitis. Of 31 cases, CPZ proved to be markedly effective or effective in 28 cases, an efficacy rate of 90.3%. CPZ was found to e ineffective in 1 case of pyothorax and 2 cases of septicemia. Of the two cases of septicemia, one who had been also suffering from ecthyma gangrenosum suspected to be caused by P. aeruginosa and died within 10 hours of admission. Therefore, it may be better to consider this case an unknown case. Side effects observed during the therapy were 1 case of rash and 1 case of a rise of BUN.
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PMID:[Experimental and clinical studies on cefoperazone (author's transl)]. 645 29

Our experience at the Ramathibodi Hospital with 20 infants and children who had Aeromonas septicemia is reviewed. Their ages were from 1 day to 14 years. Eighteen patients had underlying diseases: leukemia, 5; aplastic anemia, 4; cirrhosis, 2; thalassemia/hemoglobinopathy, 3; renal failure, 1; ileal perforation, 1; marasmus, 1; and cavernous hemangioma with thrombocytopenia, 1. Blood cultures yielded Aeromonas hydrophila in all patients, and four patients had polymicrobial bacteremia. Fifteen episodes of septicemia were community-acquired and five were hospital-acquired. The clinical manifestations of these patients were similar to septicemia due to other Gram-negative enteric bacilli. Two patients each had ecthyma gangrenosum, necrotizing fasciitis and meningitis. Antibiotic treatment included penicillins, cephalosporins, aminoglycosides and sulfamethoxazole-trimethoprim. The overall case fatality rate was 50%; eight of the nine patients with acute leukemia or aplastic anemia died. With the exception of one child the blood cultures were sterile in all patients before death. Aeromonas septicemia is an uncommon but severe infection which occurs predominantly in compromised hosts.
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PMID:Aeromonas septicemia in infants and children. 672 2

Four patterns of tissue involvement can be distinguished in sepsis due to gram-negative enteric bacilli. When intense local inflammation predominates, cellulitis or thrombophlebitis results, often with venous or arterial obstruction. Bacteria are present in the affected tissues, but not in sufficient numbers to be seen microscopically. When bacterial proliferation is unchecked by an appropriate leukocyte response, ecthyma gangrenosum, erythema multiforme, or diffuse bullous lesions may occur with minimal clinical or histologic signs of inflammation. In symmetric peripheral gangrene associated with disseminated intravascular coagulation, bland fibrinous deposits are seen in small vessels but neither inflammatory cells nor bacteria are present. The fourth kind of lesion is that seen in bacterial endocarditis. In all four patterns a vascular component is prominent clinically and histologically. The pathogenesis of these lesions is multifactorial; in each individual case the interaction between bacterial and host factors probably determines which clinical picture will result. The appearance of symmetric soft tissue lesions of the extremities in the absence of predisposing local conditions suggests the possibility of sepsis due to gram-negative bacilli, especially if other clinical features indicate that sepsis might be present.
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PMID:Cutaneous and soft-tissue manifestations of sepsis due to gram-negative enteric bacilli. 701 88

Ecthyma gangrenosum caused by Escherichia coli (E. coli) occurred in a decompensated alcoholic cirrhotic patient with spontaneous bacterial peritonitis due to the same organism. Ecthyma is usually associated with systemic sepsis from Pseudomonas aeruginosa. Isolated instances due to other bacteria have been reported, but its occurrence in spontaneous bacterial peritonitis, of which the predominant causative organism is E. coli, is unique. The frequency, varied etiology, and pathogenesis of ecthyma are briefly reviewed.
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PMID:Spontaneous bacterial peritonitis with ecthyma gangrenosum due to Escherichia coli. 704 96

Cutaneous nodules are recognized as a manifestation of disseminated candidiasis. We describe skin lesions clinically identical to ecthyma gangrenosum that, on microscopic examination, were due to Candida emboli rather than Pseudomonas sepsis. Thus, the appearance of necrotic pustules and ulcerative plaques in the immunocompromised patient would raise the possibility of Candida as well as Pseudomonas sepsis, and illustrates the diagnostic importance of skin biopsy in such cases.
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PMID:Cutaneous lesions in disseminated candidiasis mimicking ecthyma gangrenosum. 723 79

Usually, presenting infections in children with agammaglobulinemia include pneumonia and otitis media caused by pyogenic bacteria. We report here two cases of Pseudomonas aeruginosa septicemia with ecthyma gangrenosum, in previously healthy boys, leading to the diagnosis of X-linked agammaglobulinemia.
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PMID:X-linked agammaglobulinemia presenting as pseudomonas aeruginosa septicemia. 889 10

Ecthyma gangrenosum is considered as a pathognomonic sign of Pseudomonas aeruginosa sepsis. Lesions similar to ecthyma gangrenosum may be caused by other organisms. We report a case of an ecthyma gangrenosum-like eruption caused by Morganella morganii, a Gram-negative bacillus.
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PMID:Ecthyma gangrenosum-like eruption associated with Morganella morganii infection. 976 4


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