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

The antibiotic era has changed the incidence, causal factors, and gravity of empyema. Between 1977 and 1988, 27 children with empyema were surgically managed. Ten cases occurred after an operation (8 esophageal and 2 abdominal). There were 15 girls and 12 boys. The age range was newborn to 12 years. Symptoms included fever, cough, tube drainage postoperatively, anorexia, weight loss, chest pain, tachypnea, and lymphadenitis. Multiple aerobic and anaerobic organisms were cultured. Treatment included thoracentesis and antibiotics, tube thoracostomy, tube thoracostomy and bronchoscopy, decortication, or decortication with lobectomy. The total hospital stay averaged 28.3 days, and after decortication, 11.6 days. Empyemas in children frequently have multiple organisms and should be treated with broad-spectrum antibiotics while awaiting culture results. Thoracentesis and tube thoracostomy are often ineffective in curing the disease. Decortication can abbreviate hospital stay if performed promptly for persistent pleural sepsis.
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PMID:Management of empyema in children. 258 99

Acute pulmonary embolus (less than 6 weeks old) has been considered an absolute contraindication to heart transplantation for fear of the potential problems of lung abscess, empyema, bronchopleural fistula, and systemic sepsis in an immunosuppressed patient. It is difficult to adhere to this principle because 30% to 50% of patients with dilated cardiomyopathy may have an acute pulmonary embolus and would be excluded from transplantation. Several centers have considered such patients for heart transplantation if they are young, on maximal medical therapy, and in extremis. The surgical management of the postoperative pulmonary problems can include bronchoscopy, antibiotics, surgical drainage, decortication, and pulmonary resection with or without muscle flaps. We describe our approach to two such patients who were managed successfully with lobectomies and latissimus dorsi muscle flaps to seal the bronchus and fill the pleural space.
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PMID:Successful heart transplantation in recipients with recent preoperative pulmonary emboli. 261 52

We have treated 42 episodes of pediatric infections with sulbactam/ampicillin since 1987. Included were 9 cellulitis, 9 urinary tract infections, 5 cervical lymphadenitis, 4 meningitis, 2 thoracic empyema, 2 osteomyelitis, 2 sepsis, 1 furuncle, 1 perianal abscess, 1 dental abscess, 1 peritonsillitis, 1 salmonellosis, 1 shigellosis, 1 peritonitis, 1 suppurative thyroiditis, 1 infective endocarditis. Responsible pathogens were Escherichia coli in 8, Staphylococcus aureus in 6, Hemophilus influenzae in 2, Streptococcus pneumoniae in 3, Streptococcus viridans in 2, Staphylococcus epidermidis in 1, Bacteroides fragilis in 1, Salmonella D1 in 1, Shigella sonnei in 1, Klebsiella pneumoniae in 1, Enterobacter agglomerans in 1, Acinetobacter calcoaceticus in 1, Enterobacter cloacae in 1, group A beta-hemolytic streptococcus in 1, and polymicrobial infection in 4 cases. Thirty-nine out of 41 (95%) clinically evaluable patients cured and all (34/34) bacteriologically evaluable patients eradicated their pathogens after treatment with sulbactam/ampicillin. Side reactions were seen in five patients; one maculopapular skin rash, one hemolytic anemia, two diarrhea, and one liver function impairment plus leukopenia. All these reactions were transient and did not require interruption of therapy. These results indicate that sulbactam/ampicillin is safe and effective in the treatment of common pediatric infections beyond the neonatal period.
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PMID:A clinical evaluation of sulbactam/ampicillin in the treatment of pediatric infections. 263 93

In childhood perianal fistulas are frequent. The origin of the fistula is the anorectal line, especially from the Morgagni crypts. Local recurrence of abscesses are observed. Due to two observations we conclude that the fistulas caused a sepsis with E. coli. In one case meningitis and a consecutive empyema occurred, in a second case pyelonephritis. In the following we describe the patient with meningitis and subdural empyema.
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PMID:[Perianal fistula as a cause of meningitis?]. 268 68

A combination drug of sulbactam/ampicillin (SBT/ABPC) was intravenously administrated to 18 patients with ages 3 months to 10 years 10 months with various acute infections including 14 cases of pneumonia, 1 case each of tonsillitis, subacute bacterial endocarditis, empyema and suspected sepsis. Clinical responses were excellent in 14 cases and good in 4 cases. Bacteriological responses of 8 isolated strains were: 7 strains were eradicated and 1 strain was decreased. No side effect was observed in any case. Eosinophilia was observed in 2 cases, thrombocytosis in 2 cases, elevation of GOT in 1 case and elevations of GOT and GPT in 1 case. From the above results, it seemed that SBT/ABPC was a useful drug for the treatment of bacterial infections in the pediatric field.
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PMID:[Clinical study on sulbactam/ampicillin in the pediatric field]. 274 52

Of 330 consecutive patients with liver trauma having a celiotomy over a 5-year period, 295 (89%) survived more than 72 hours. Of these 295, 35 (12%) developed sepsis, and 11 (31%) of these septic patients died. The sources of the sepsis in 30 of these patients included: abdominal abscesses--23, pneumonia or empyema--seven, acalculous cholecystitis--two, gangrene of right colon--two, and thigh abscess--one. In five other patients, the source of the sepsis was not found, even at autopsy. The mortality rate in the 30 patients with one or more identifiable foci of infection was 23%. In contrast, when the source of the sepsis could not be found, the mortality rate was 80% (4/5) (p less than 0.05). Factors associated with an increased incidence of abdominal abscess included: splenectomy, 75% (3/4); liver packs, 63% (5/8); 20+ units of blood, 57% (8/14); Class IV-V liver injury, 35% (8/23); 10-19 units of blood, 25% (7/28); colon injury, 19% (7/36); and open (Penrose) drainage of the abdomen, 11% (23/213). None of 82 patients without drains developed an intra-abdominal abscess. Thus early control of an identifiable source of infection provides the best results with sepsis following liver trauma. The most effective method for preventing intra-abdominal abscesses appears to be avoidance of drains in mild (Class I-II) liver injuries. The use of a closed system in the most severe injuries is still controversial and needs to be addressed in a prospective trial.
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PMID:Intra-abdominal sepsis following liver trauma. 276 Sep 54

Spontaneous rupture of the esophagus (Boerhaave's syndrome) has a dismal survival rate without prompt surgical management. A variety of surgical regimens have achieved survival of 70% or greater; however, the postoperative course is frequently complicated by fistula, would infection, empyema, and sepsis. We report an unusual postoperative chest wound infection of clostridial myonecrosis, which presumably originated from the patient's gastric microflora. He was treated with immediate surgical debridement of all involved tissue, prolonged ventilation, total parenteral nutrition, and frequent dressing changes. The remaining defect was closed with a skin graft. Anaerobic wound infections of the chest wall and their management are discussed.
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PMID:Clostridial myonecrosis of the chest wall complicating spontaneous esophageal rupture. 286

21 patients with thoracic empyema were treated at this clinic over a period of 3 years. 15 patients had metapneumonic empyema, 2 empyema associated with sepsis, and 4 postsurgical empyema. In 12 patients the underlying illness was chronic disease while 9 patients were thus far in good health. The most frequent causative pathogens were staphylococci and streptococci, together with anaerobic bacteria. One patient died of the underlying disease. Three cases of metapneumonic empyema healed completely with antibiotics only. Closed chest tube drainage with small chest tube was performed 13 times and was successful 11 times with a mean drainage duration of 13 days. Six patients underwent surgery (early decortication in 4 instances, late decortication in 2). The surgical indication was in 4 instances multilocular of the empyema which inhibited chest tube drainage, imminent loss of function in 1 case and unsuccessful drainage in a case of bronchopleural fistula in 1 instance. Apart from high-dose antibiotic therapy, earliest possible drainage is of crucial importance in the treatment of thoracic empyema. Surgery should be considered only in uncomplicated empyema if drainage is impossible for technical reasons.
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PMID:[Diagnosis and therapy of pleural empyema]. 318 79

Actinobacillus species are usually not considered as being human pathogens apart from A. actinomycetemcomitans. However, single cases of human meningitis, septicemia, and empyema caused by Actinobacillus lignieresii have been reported in the literature. This is the first reported case of Actinobacillus hominis giving rise to pleural-empyema in a patient with carcinoma of the lung. The function of peripheral blood neutrophils, serum opsonic activity and specific precipitating antibodies were investigated. Neutrophils from the patient exhibited an enhanced oxidative burst response measured by chemiluminescence assay. Furthermore, the opsonic activity of the serum from the patient was higher than that of a healthy control person. Several precipitating antibodies to various antigens of Actinobacillus hominis were demonstrated in the serum of the patient by crossed immunoelectrophoresis.
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PMID:Neutrophil response, serum opsonic activity, and precipitating antibodies in human infection with Actinobacillus hominis. 319 73

One hundred consecutive patients underwent surgical procedures for empyema. Sixty-six patient acquired empyema from pneumonia, 16 from trauma, 11 from abdominal sepsis, and 7 from other causes. If tube thoracostomy failed, computerized tomography and ultrasonography were used to demonstrate a loculated empyema. After a median observation period of 11 days, 91 patients underwent thoracotomy and decortication and 9 patients underwent either rib resection, an Eloesser flap procedure, or both. The mortality rate was 6 percent 30 days postoperatively, the in-hospital mortality rate was 9 percent, and the overall morbidity rate was 17 percent. An excellent result was achieved in 85 percent of the patients with a recurrence rate of 4 percent. Gram-positive aerobes were the most common organisms cultured, but several opportunistic infections were encountered. We have concluded that early thoracotomy and decortication of empyema results in eradication of difficult pleural infections with hospital stays of an acceptable length and reasonably low morbidity and mortality rates.
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PMID:Management of refractory empyema with early decortication. 320 67


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