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

Here we describe a case of Reye syndrome diagnosed at postmortem liver biopsy of a three-year old girl who presented with vomiting, low grade fever for three days and loss of consciousness for 18 hours. Clinically, the differential diagnoses were meningitis, encephalitis and septicemia. No history of past illness or any drug ingestion including aspirin were present. Laboratory investigations indicated a diagnosis of Reye syndrome. The child was given supportive treatment but died after two days of admission and postmortem needle-biopsy of the liver showed microvesicular steatosis consistent with Reye syndrome.
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PMID:Reye syndrome: a case report with review of literature. 1855 90

Neonatal entero-viral sepsis is a rare but fulminant infection with multisystem involvement, often presenting with hepatitis, meningo-encephalitis, disseminated intravascular coagulation (DIC), and myocarditis. Neonatal myocarditis often proves fatal. We report here a case of neonatal enteroviral myocarditis with multisystem organ failure and ischemic cardiomyopathy that was managed medically.
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PMID:Enteroviral sepsis and ischemic cardiomyopathy in a neonate: case report and review of literature. 1881 54

Alpha coma, an EEG pattern characterized by diffuse or widespread rhythmic activity in the alpha frequency band, is typically recorded in patients with profound coma and is frequently associated with severe neurological conditions. The most common etiologic factors of this pattern are hypoxic-ischemic encephalopathy, encephalitis, head trauma, metabolic disorders, and drug overdose. Reports of alpha coma pattern in children are relatively common. Clinical significance, both in children and adults, is variable, and highly dependent on etiology. The objective of this article is to report a clinical case of alpha coma pattern in a child with neuroblastoma. The EEG pattern was recorded during the evolution of treatment, secondary to complicating septic encephalopathy. The alpha coma pattern was replaced by a normal trace following a favorable outcome after sepsis resolution.
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PMID:Alpha coma pattern in a child. 1904 20

Chromobacterium violaceum infections are highly fatal and rarely reported in domestic animals. This report describes a fatal case of C. violaceum septicemia in a 7-day-old female beef calf. The calf had necrosuppurative omphalophlebitis, necrotizing interstitial pneumonia, necrosuppurative hepatitis and splenitis, anterior uveitis with hypopyon, suppurative polyarthritis, and disseminated hemorrhagic meningitis with multifocal necrotizing encephalitis. Histologically, clusters of gram-negative bacilli were found in many of the lesions. C. violaceum was isolated in high numbers from the lungs, liver, spleen, carpus, and in pure culture from the cerebrospinal fluid. To our knowledge, this is the first case report of chromobacteriosis in a calf.
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PMID:Septicemia in a neonatal calf associated with Chromobacterium violaceum. 1911 18

A 69-year-old male was presented with a 2-month history of cognitive decline. The most profound deficit was observed in short-term verbal and visual memory and recognition. He was otherwise healthy, apart from atrial fibrillation diagnosed 5 months before. Brain MRI revealed T2 hyperintensities in the left thalamus, right pulvinar thalami, both putamina and right head of caudate nucleus without diffusion restriction on DWI sequences. CSF examination revealed elevated proteins. He was HIV negative. The course of the disease was complicated with gram negative sepsis and the patient died 14 days later. Autopsy revealed the brain lesions to have been caused by toxoplasmic encephalitis. Toxoplasmic encephalitis is an extremely rare cause of rapidly progressive dementia in immunocompetent patients. In patients with multiple lesions, hyperintense on T2 and hypointense on T1 weighted sequences, without diffusion restriction and some expansive effect, infectious causes should be considered, even in the absence of classical signs of infectious diseases and CSF pleocythosis.
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PMID:Unusual cause of dementia in an immunocompetent host: toxoplasmic encephalitis. 1914 71

The aim of this study was to evaluate the accuracy of procalcitonin (PCT) in predicting infective endocarditis (IE). 23 adult patients with IE, 30 patients with sepsis and 30 with tick-borne encephalitis were included in this prospective study. The PCT serum level, C-reactive protein (CRP), total leukocyte, and immature polymorphonuclear (PMN) cell counts were determined on admission, prior to the institution of antibiotic therapy, and compared according to the diagnosis. The median PCT level in patients with IE endocarditis was 0.81 ng/ml, in patients with sepsis it was 43.74 ng/ml, and in the group with viral infection it was 0.25 ng/ml (P < 0.001). The highest PCT level was found in patients with Staphylococcus aureus endocarditis. The area under the receiver operating characteristic curve that used PCT to predict IE was 0.722 (95% CI 0.572-0.873), compared with 0.909 (95% CI 0.829-0.989) for CRP, 0.699 (95% CI 0.551-0.846) for immature PMN cell count, and 0.619 (95% CI 0.468-0.770) for leukocyte count. Our study fails to demonstrate superiority of PCT as a diagnostic laboratorial parameter in predicting IE compared to CRP.
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PMID:Usefulness of procalcitonin for diagnosis of infective endocarditis. 1935 24

Candida endocarditis was previously considered a rare disease. However, its incidence is increasing, partly as a consequence of increased use of prosthetic intravascular devices. In patients with prosthetic valve endocarditis, Candida infection may occur via a two-step process; firstly, post-operative transitory candidaemia occurs during the intensive care unit stay, leading to colonization of the prosthetic valve and subsequent biofilm formation, with reduced susceptibility to antifungal agents. This theory lends support for pre-emptive antifungal therapy with agents that display activity against biofilm-associated Candida in patients with prosthetic heart valves at risk of candidaemia. Current guidelines recommend treatment with amphotericin B with or without 5-fluorocytosine, or an echinocandin, with valve replacement where possible. Recent data suggest that amphotericin B shows reduced activity against Candida biofilm, and poor penetration into vegetations and blood clots in experimental models of infectious endocarditis, whereas echinocandins, and in particular anidulafungin, display potent in vitro activity against sessile Candida cells within biofilms. The incidence of ocular candidiasis has been decreasing among inpatients with candidaemia, possibly because of earlier identification and treatment of candidaemia. The therapeutic approach includes prolonged treatment with fluconazole or voriconazole. The role of systemic echinocandins may be limited since they achieve undetectable vitreous concentrations. Vitrectomy with local instillation of amphotericin B, azoles or echinocandins may play a role in the treatment of chronic complications such as epiretinal membrane formation. The role of Candida in CNS infections is unclear. Diffuse encephalitis in candidaemia is misleading, since alterations of the mental status are generally attributed to candidaemia-associated sepsis syndrome, and neuroimaging studies and cerebrospinal fluid cultures are rarely performed as part of the diagnostic work-up. Osteomyelitis caused by Candida is considered infrequent. In contrast, Candida is frequently implicated in nosocomial non-postneurosurgery spondylodiscitis. Optimal management of such cases may require surgical debridement and, after initial intravenous antifungal therapy, prolonged administration of oral azoles. The role of Candida in endocarditis is fairly well established. With the increasing numbers of patients at risk of Candida endocarditis, there is a need for agents with potent efficacy against Candida biofilms. Echinocandins represent a potential therapeutic option in this setting. Antifungal agents may also be of use in the treatment of complications in patients with ocular candidiasis and in CNS infections.
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PMID:Clinical aspects of invasive candidiasis: endocarditis and other localized infections. 1987 33

Acute liver failure is a life threatening disease mostly triggered by drug-induced or toxic liver damage or viral hepatitis. Herpes Simplex virus (HSV) hepatitis is rare and accounts for only 1% of all acute liver failures. The importance of HSV-induced acute liver failure is based on its extremely severe clinical course with lethality rates of almost 75%. HSV hepatitis is just one of several clinical manifestations of HSV sepsis leading more frequently to encephalitis, pneumonia and esophagitis. Local herpes infection or recurrence of dermal lesions (herpes labialis, herpes genitalis), however, is common and account for the high prevalence of HSV-1 or HSV-2 infection in adults. Another rare entity is visual dissemination, which mostly affects immunocompromised patients. Compromised cellular immunity is a major risk factor for HSV sepsis because of either primary infection or reactivation of occult chronic HSV infection. Delayed diagnosis without antiviral therapy significantly contributes to the unfavorable outcome. Typically, anicteric hepatitis is seen in patients with HSV hepatitis. Because of its low incidence, however, and the lack of dermal manifestations, HSV hepatitis is rarely considered in the context of acute liver failure. In addition, diagnostic tests might not always be available. Therefore, it is a generally accepted consensus to begin antiviral therapy pre-emptively with acyclovir in cases of acute liver failure of unknown origin, in which high urgency (HU) liver transplantation remains the only therapeutical option. Even in the case of early specific therapy, sepsis may prevail and the indication for HU transplantation must be evaluated carefully. The outcome after liver transplantation for HSV-induced liver failure with reported survival rates of more than 40% is good. Because of the risk of recurrence, lifelong prophylaxis with acyclovir is recommended.
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PMID:Herpes simplex virus sepsis and acute liver failure. 1993 Mar 15

Herpes simplex virus (HSV) hepatitis has a fatal impact on the outcome of organ transplanted recipients. Here, we present a thought-provoking case of HSV hepatitis in a high-risk recipient after living-related liver transplantation (LRLT). A 1-month-old female newborn infant was affected by HSV encephalitis. Fulminant hepatic failure (FHF) of unknown etiology occurred suddenly at 4.4 years of age. Viral infections were ruled out as the cause of FHF. Intensive care including plasma exchange (PE) was started, and the preoperative treatments for ABO incompatibility were performed. Thereafter, LRLT was performed emergently. Although strong immunosuppression for ABO incompatibility was continued after LRLT, antibody-mediated rejection (AMR) occurred on postoperative day (POD) 4. PE was repeated and improvements were obtained. However, liver dysfunction appeared on POD 8. Histopathological findings of liver needle biopsy clearly revealed HSV hepatitis, although the results of HSV DNA and antibody titer in blood sample did not clearly indicate HSV infection. On POD 21, thrombotic microangiopathy (TMA) occurred and the plasma and immunoglobulin were replenished. Our pediatric recipient recovered successfully from AMR, HSV hepatitis, TMA, and repeated sepsis. We conclude that well considered therapy based on the real-time detection of HSV hepatitis is indispensable for the further improvements of outcome in HSV hepatitis after LRLT.
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PMID:Herpes simplex virus hepatitis after pediatric liver transplantation. 2003 Jul 95

Human enteroviruses are associated with various clinical syndromes from minor febrile illness to severe, potentially fatal conditions like aseptic meningitis, paralysis, myocarditis, and neonatal enteroviral sepsis. Between June 2000 and August 2008 echovirus (E) type 2, 4, 6, 7, 9, 11, 13, 25, 30, coxsackievirus (CV) -A16, -A19, -B5, and enterovirus 71 (EV71) were reported in Hungary. In this study, 29 previously enterovirus positive samples from 28 patients diagnosed with hand, foot and mouth disease, meningitis and encephalitis, were molecularly typed. The genetic relationships of identified serotypes CV-A16, EV71, and E30 were assessed by direct sequencing of genomic region encoding the capsid protein VP1. The sequences were compared to each other and sequences from other geographical regions possessed in Genbank. The phylogenetic analysis of CV-A16 revealed that the viruses were mostly of Far-Eastern or Asia-Pacific origin. Typing of EV71 showed that one virus from 2000 belonged to genotype C1 and five viruses observed in 2004 and 2005 were identified as genotype C4. The 11 echovirus 30 strains showed homology with those of neighbor European countries. The molecular examination of E30 revealed that three separate lineages circulated in 2000, 2001, and 2004-2006 in Hungary.
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PMID:Detection of non-polio enteroviruses in Hungary 2000-2008 and molecular epidemiology of enterovirus 71, coxsackievirus A16, and echovirus 30. 2004 91


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