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

The most common forms of Listeria monocytogenes infection in adults are meningitis-encephalitis and sepsis. Infection of the pulmonary parenchyma and pleura have rarely been reported. A case of listeria meningitis presenting with pleural space infection in an immunosuppressed patient is presented and a review of 5 additional patients with listeria infection of the respiratory tract is included. All 6 patients described in this report had L. monocytogenes infections presenting with respiratory tract symptomatology, although 4 patients subsequently had positive blood or cerebrospinal fluid cultures. It is emphasized that a culture report of 'diphtheroids' from a thoracentesis specimen should not be automatically dismissed as contamination, particularly in an immune compromised patient.
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PMID:Pleural-pulmonary aspects of Listeria monocytogenes infection. 683 91

Mice immunized with a killed vaccine of phase I Bordetella bronchiseptica were challenged with various numbers of virulent B. bronchiseptica by intraperitoneal, intracerebral, or intranasal routes. The course of infection was compared among these routes, and the protective effect of vaccination was quantitatively analyzed. In ddN mice infected intraperitoneally with 1.8 X 10(8) cells (ca. 80 times the 50% lethal dose [LD50]) the organisms rapidly increased in the intraperitoneal fluid, spleen, and liver within few days and caused splenic atrophy, septicemia, and death. However, immunizations with 5 X 10(9) cells gave the mice a high agglutinin titer and suppressed the increase in the number of organisms. With four immunizations, the lungs and livers were clear within 3 days, and with one or two immunizations, they were clear within 7 days. These immunizations effectively protected the mice from death but did not protect them from splenic atrophy. In the intracerebral infection with 1.4 X 10(6) cells (ca. 1.2 X 10(5) LD50), the number of organisms rapidly increased in the brain and caused encephalitis, splenic atrophy, and death. However, four or five immunizations completely suppressed the increase in the brain and protected the mice from death and splenic atrophy. After intranasal infection with 4 X 10(6) cells (ca. 25 LD50), the organisms rapidly increased in the nasal cavity and lungs and caused pneumonia and death. Immunization with 5 X 10(9) cells was effective in clearing the organisms from the lungs and in protecting against death and splenic atrophy. However, the organisms were not cleared from the nasal cavity for 60 to 150 days after the challenge with as little as 10(2) cells, even in the mice with an agglutinin titer as high as 1:10,000.
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PMID:Protection against experimental Bordetella bronchiseptica infection in mice by active immunization with killed vaccine. 687 70

Six infants with disseminated HSV had no mucocutaneous lesions at any time during the course of the illness. These infants presented with lethargy, poor feeding, apnea, acidosis, and hepatomegaly. The diagnosis of HSV was made by culturing the infant's oropharynx and blood, and the maternal cervix. Eight infants with HSV encephalitis had no skin, eye, or mucous membrane lesions. These infants presented with lethargy and low-grade fever, followed within 24 hours by the onset of focal partial motor seizures. The seizures were refractory to anticonvulsant therapy. The mean CSF white cell count was 131 cells/mm3;the glucose and protein concentrations were in the normal range. Brain biopsy was required for the early diagnosis of HSV encephalitis. These 14 cases presented 70% (14/20) of all infants with neonatal HSV diagnosed during the study period. HSV infection should be considered in infants with no mucocutaneous lesions who have signs usually associated with bacterial sepsis or who develop focal seizures during the first three weeks of life.
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PMID:Neonatal herpes simplex infection in the absence of mucocutaneous lesions. 706 32

We reviewed the records of 96 children hospitalized with varicella from July 1, 1975 to June 30, 1980. Eighty-one were immunologically normal and 15 were immunocompromised on the basis of neoplasia, immunosuppressive therapy, or genetic disease. These children experienced 106 complications including viral dissemination-encephalitis (44), bacterial infection (25), Reye's syndrome (17), unusual cutaneous lesions (eight), drug overdose (five), diabetic ketoacidosis (two), neonatal infection (two), dehydration (two), and exacerbation of preexisting nephrosis (one). The length of hospitalization varied from one to 38 days with a median of five days. There were ten varicella pneumonia (one), of neonatal varicella (one), and of a ruptured mycotic aneurysm secondary to septicemia (one). This review demonstrates (1) a substantial occurrence of life-threatening complications of varicella in childhood, and (2) a need for prospective epidemiologic data on the incidence of complications to determine the scope and extent of varicella vaccination.
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PMID:Life-threatening complications of varicella. 729 88

All cases referred for computed tomography (CT) from a 48-bed infectious disease unit over a 3-year period were reviewed. Thirty patients were examined on 45 occasions with head and body cases approximately equal in number. Positive diagnoses were made in 38 examinations (84%), although this included 3 incidental findings. The most common indication for CT was exclusion of cerebral abscess presenting as meningitis (11 cases). The most common disease was tuberculosis (12 cases), although a wide spectrum of disease including four noninfective cases was encountered. CT made a direct contribution to the management of patients with meningitis, encephalitis, cerebral abscess, septicemia, hepatic abscess, tuberculosis, and lymphoma. Although CT was only utilized in a small proportion of patients admitted to this unit, the technique provided valuable information in the management of a number of problematic cases.
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PMID:Role of computed tomography in the management of infectious disease. 731 68

Your recent lead article on toxic shock and tampons (November 1, p. 1161) prompts me to report a case of pelvic infection and staphylococcal septicemia 8 days after the insertion of a Lippes loop. Pelvic infection is a recognized complication of IUDs; although there have been 2 reports of endocarditis occurring in susceptible patients following the insertion of an IUD, septicemia is rare. A previously healthy 31-year old married woman had a loop inserted at a family planning clinic. 3 days later she developed sweating, vomiting, confusion, and cough and during the following 48 hours became disoriented with hallucinations. She was referred to the hospital with suspected encephalitis and on admission was febrile (38.8 degrees Celsius) and stuporose but responded to simple commands. Blood pressure was 95/60 mmHg but there were no other abnormal signs. Hemoglobin was 12.2 g/dl, white blood count 4.0x109/1 (80% neutrophils), erythrocyte sedimentation rate 70mm in the 1st hour; cerebrospinal fluid normal. Chest x-ray examination revealed patchy consolidation in the upper lobes of both lungs and an electroencephalogram showed bilateral nonspecific abnormality. 3 blood cultures taken on admission yielded penicillin-resistant Staphylococcus aureus. She was treated with high-dose intravenous cloxacillin and 24 hours after starting the antibiotic had improved markedly and the IUD was removed. Culture from the coil and also from a high vaginal swab yielded Staph aureus with a similar antibiogram to that of the organism cultured from the blood. Subsequent recovery was uneventful, although repeat chest x-ray examination showed small abscess cavities in the upper lobes of both lungs. The patient was discharged 4 weeks after admission and serial chest radiographs have confirmed complete resolution of the pneumonia and abscesses. There is little doubt that this patients' septicemia with lung abscess formation and encephalopathy originated in the genital tract. The patient was both toxic and shocked but was different from patients with the recently described toxic shock syndrome in that her blood culture was positive for Staph aureus. The case provides another example of the importance of this organism as a cause of infection associated with the insertion of foreign bodies into or through the vagina.
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PMID:Staphylococcal septicaemia after insertion of an intrauterine contraceptive device. 744 49

Beta 2-microglobulin (beta 2m) determination in CSF of 72 neonates who underwent a spinal tap as part of a sepsis or meningo-encephalitis workup was performed to evaluate the usefulness of this test in the diagnosis of CNS infections. Beta 2m was measured by enzyme immunoassay. Sixty neonates had sterile culture and normal neurological status at discharge. Twelve infants had CNS infections: 8 bacterial meningitis, 3 TORCH infections (T = toxoplasmosis, O = others, R = rubella, C = cytomegalovirus and H = herpes simplex) and 1 viral meningitis. Neonates with CNS infection exhibited significantly higher CSF beta 2m levels compared to neonates with sterile culture (6.24 +/- 2.66 vs 1.74 +/- 0.5 mg/l; P < 0.0001). CSF beta 2m levels did not correlate with the white cell count, total protein concentration or glucose level in CSF. When serum and CSF levels were measured simultaneously, the CSF beta 2m level was significantly higher than the corresponding serum level in patients with CNS infection (6.98 +/- 2.5 vs 3.2 +/- 0.25 mg/l; P < 0.01). Sensitivity, specificity, and predictive values were estimated for different cut-off points. The best operational diagnostic cut-off value was 2.25 mg/l. Receiver operating characteristic curve analysis showed an appropriate trade-off between specificity and sensitivity and indicated that CSF beta 2m was accurate in distinguishing between neonates with and without CNS infection. Conclusion. CSF beta 2m may be a useful ancillary tool in neonates when CNS infection is suspected.
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PMID:Cerebrospinal fluid beta 2-microglobulin in neonates with central nervous system infections. 760 83

This prospective study evaluated the frequency, clinical characteristics and causes of hyponatremia (serum sodium < 130 mEq/L) in 727 children upto 12 years of age, who were brought for emergency care, and needed hospitalization. Hyponatremia was found in 29.8% and was more frequent in summer (36%; 123/341) than in winter (24%; 94/386) (p < 0.001). Acute lower respiratory infections (pneumonia) and acute diarrhea each accounted for 20% cases of hyponatremia; others were accounted for by meningitis/encephalitis (12%) septicemia (8%), and renal, heart and liver diseases (6-7% each). Clinical evaluation and concurrent plasma and urinary osmolality and urine sodium suggested that hyponatremia associated with pneumonia, meningitis/encephalitis, septicemia, seizures and miscellaneous diseases was of hypotonic-euvolemic (dilutional) type in more than 80% patients while in all children with acute diarrhea it was of hypovolemic type. The study has shown that hyponatremia occurs frequently in sick children requiring emergency care, especially in summer months, and should receive appropriate attention in the management plan.
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PMID:Hyponatremia in sick children seeking pediatric emergency care. 789 63

Although infrequent, untreated neonatal herpes results in death in half the cases and neurologic sequelae in three quarters of the survivors. Neonatal infection is usually acquired from maternal genital herpes, which is asymptomatic or unrecognized in 60% to 80% of women. The greatest risk of neonatal infection occurs when the mother has primary genital herpes involving the cervix at delivery, and the infant is premature and delivered with instrumentation (eg, scalp electrodes). More than 80% of neonates with herpes will have typical herpetic lesions of the skin, eye, or mouth, and most of the remainder will have either encephalitis or a sepsis syndrome with pneumonitis and hepatitis and negative bacterial cultures. Because herpes can mimic other neonatal infections, laboratory diagnosis is important, using cultures of the virus from lesions, peripheral blood white cells, or CSF. Treatment with intravenous acyclovir does reduce mortality and neurologic sequelae, but outcome is still guarded in babies with disseminated disease or encephalitis. Prevention focuses on caesarean section in women with active lesions at the time of impending delivery and avoidance of postnatal exposure. Further studies are needed to determine whether maternal screening (eg, HSV-2 type specific antibodies and vaginal cultures in selected women at delivery) will be cost effective in preventing neonatal herpes.
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PMID:Herpes simplex virus infection of the fetus and newborn. 801 61

Examinations of 202 newborn babies for a representative group of viral infections by detection of viral antigens in cells of urine sediment and in the autopsy materials by indirect immunofluorescence permitted diagnosis of a congenital viral infection in 92% of patients with intrauterine and perinatal pathology; in 72.5% it was a mixed infection. In the patients the virus-virus associations were, as a rule, represented by enteroviruses of Coxsackie group and/or influenza A, B, and C viruses. Most frequently (83.3-100%) mixed virus infection was detected in newborn babies with the severest pathology (meningoencephalitis, encephalitis, sepsis, intrauterine pneumonia), as well as in fatal cases.
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PMID:[The significance of a mixed congenital viral infection in human antenatal and perinatal pathology]. 801 58


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