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

During a 3 year period, 1987-1989, we encountered three major complications associated with parenteral nutrition leading to congestive cardiac failure--acute beriberi, right atrial and superior vena caval thrombosis, and fungal endocarditis. Unrecognized, these are invariably fatal. Persistent vomiting from intestinal obstruction led to the development of thiamine deficiency in the patient with beriberi. Recurrent catheter tip sepsis probably accounted for thrombosis and endocarditis in the second and third cases, respectively. These conditions are preventable with careful attention to nutritional replenishment and aseptic technique. In patients with catheter-related sepsis early, repeated blood culture is of diagnostic value. Patients with Staphylococcus aureus catheter-associated bacteraemia require at least 4 weeks of appropriate antibiotic therapy. Recurrent sepsis, especially when associated with pulmonary embolic phenomena, is an indication for echocardiography.
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PMID:Cardiovascular complications of parenteral nutrition. 144 2

Human infection with Pasteurella multocida is the leading cause of animal bite wound infection. Life-threatening infection may occur in patients with a variety of underlying disorders and an immunocompromised state. Infective endocarditis with P. multocida is very rare and only a few clinically diagnosed cases have been reported. Described here is an autopsy case of a 61-year-old man with polycystic kidney disease who had P. multocida bacteremia and acute infective endocarditis with multiple bacterial clumps involving bicuspid aortic valve. The organisms were gram negative. Apparently the sepsis with P. multocida was acquired via licking of leg ulcers by his pet dog, establishing an animal-related causal relationship. Because P. multocida is a very common flora of many animals, infection with this organism probably occurs more frequently than is commonly appreciated. High index of suspicion and early diagnosis, especially in immunocompromised patients, are warranted because the disease is potentially life threatening, yet is a readily treatable infection.
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PMID:Pasteurella multocida endocarditis. 146 53

Staphylococcus aureus (SA) is among the most important causes of skin infections. The incidence of Methicillin-resistant SA (MRSA) strains isolated from skin and skin structure infections was about 20-40%. In deep-seated pyoderma such as furuncle and furunculosis, MRSA was more frequently isolated than in other type of infectious diseases of the skin. But the incidence was gradually increasing. As to coagulase typing, type IV was most frequently isolated in MRSA. The damaged skin is easily colonized by high numbers of SA on its surface and within hair follicles. Through the indwelling catheters or decubitus SA on the skin could cause easily severe systemic MRSA infections such as sepsis or endocarditis of in-patients.
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PMID:[Methicillin-resistant Staphylococcus aureus in dermatology]. 150 40

Infective endocarditis is uncommon in young children, especially in the absence of structural heart disease. We report the case of a 2-year-old boy who presented with acute rupture of the mitral valve chordae 6 weeks after an episode of Fusobacterium necrophorum septicemia. His heart had been structurally normal before. Mitral valve replacement was successfully performed. This is the first recorded case of endocarditis in a child caused by necrobacillosis.
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PMID:Endocarditis with acute mitral regurgitation caused by Fusobacterium necrophorum. 151 43

MDL 62,873 is an amide derivative of teicoplanin A2-2. Like those of natural glycopeptides, its antibacterial activity is mediated by inhibition of cell wall peptidoglycan synthesis. Against streptococci and enterococci, the in vitro activity of MDL 62,873 was similar to that of teicoplanin and greater than that of vancomycin. Against staphylococci, it has activity similar to that of vancomycin, and it was significantly more active than teicoplanin against coagulase-negative isolates. Like teicoplanin and vancomycin, MDL 62,873 had slow but significant bactericidal activity (99 to 99.9% killing in 24 h) against staphylococci at concentrations near the MIC. In murine septicemia studies with Staphylococcus aureus, Streptococcus pyogenes, and Streptococcus pneumoniae, the 50% effective doses were lower than those of vancomycin. In staphylococcal endocarditis in rats, MDL 62,873 at 20 mg/kg of body weight and vancomycin at 40 mg/kg, both doses given intravenously twice daily, had similar efficacies in reducing the heart bacterial load. These results probably reflect the longer half-life of MDL 62,873, which has a pharmacokinetic profile in rats similar to that of teicoplanin.
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PMID:Antimicrobial activity of MDL 62,873, a semisynthetic derivative of teicoplanin, in vitro and in experimental infections. 153 78

This report reviews 45 episodes of group A streptococcal bacteremia during 1980-1989 in a large hospital; 24 episodes occurred in the first 5 years of study (1980-1984) and 21 in the last 5 years (1985-1989). Four episodes were nosocomial. The remaining 41 episodes were community acquired; of these episodes, 12 occurred in patients who were transferred from nursing homes. There was a definite seasonal predominance (84%) during November-June. All but three patients had chronic underlying conditions. The major portals of entry were the skin and lungs, and the main types of infection were primary septicemia, cellulitis and soft-tissue infection, pneumonia, and infective endocarditis. The overall mortality rate was 24%; 20% of the deaths were due to infection. Factors that adversely influenced mortality were septic shock (P less than .02), less than 10,000/mm3 leukocytes (P less than .05); less than 80% segmented polymorphonuclear leukocytes and band forms (P less than .02), and hyperbilirubinemia (P less than .01). Neither prevalence nor severity of group A streptococcal bacteremia increased during the last 5 years of study.
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PMID:Group A streptococcal bacteremia in a community teaching hospital--1980-1989. 157 44

Over the last two decades, the optimal duration of therapy for catheter-related Staphylococcus aureus bacteremia has become the subject of controversy. A review of the literature revealed an occasional association between relapse of the infection and a short course of therapy (less than 10 days of iv antibiotic therapy). From records kept between 1983 and 1989 at the University of Florida's affiliated hospitals, we identified 55 patients with catheter-related S. aureus bacteremia. Nine patients (16%) developed acute early complications (e.g., endocarditis or osteomyelitis) while receiving antibiotics. The results of multivariate analysis showed that an early complicated course was characterized by fever and/or bacteremia that persisted for greater than 3 days after catheter removal (P = .02). The remaining 46 patients were followed up for at least 3 months. During follow-up, three of the 18 patients treated for less than 10 days with iv antibiotics developed relapsing septicemia, whereas none of the 28 patients treated for a longer period developed this condition (P = .05). Fever and/or bacteremia that persists for greater than 3 days after catheter removal and initiation of antibiotic therapy suggests an acutely complicated course requiring prolonged treatment. The duration of iv antibiotic therapy in uncomplicated cases should not be less than 10 days but need not be greater than 2 weeks.
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PMID:Optimal duration of therapy for catheter-related Staphylococcus aureus bacteremia: a study of 55 cases and review. 162 83

alpha-Hemolytic streptococci, variously described as cell-wall deficient (C), L form (L), thiol dependent (O), satelliting (S), pyridoxal dependent (PY), and nutritionally deficient (N), or CLOSPYN, were isolated from patients with endocarditis, brain abscess, subauricular abscess, septicemia, acute and chronic urethritis, recurrent aphthous stomatitis, and fever of undetermined origin. With the aid of satelliting, most of the strains were adapted to grow on a human Mycoplasma growth agar consisting of brain-heart infusion agar fortified with 20% human blood, yeast extract, and arginine. Selected CLOSPYN strains required extensive subculture for only partial reversion to parentallike characteristics. Four of six strains biochemically tested were judged Streptococcus morbillorum. Two were unidentifiable. The CLOSPYN form was relatively inert biochemically, but glucose was converted mainly to lactic acid, with acetic acid also present. Guanine-cytosine values were 39%-43%. Cell wall material was present by transmission electron microscopy (TEM), but its synthesis was uneven on single cells and abnormally thickened on other cells. Closely spaced, incompleted septa occurred in cell chains, which resulted in unusually long chains of flattened cells resembling on TEM a stack of checkers. Mesosomes were frequent, greatly enlarged, convoluted, and elongated. They were often sectioned as circular and laminated, with 2-5 layers. Mesosomes were in close contact with nucleoid bodies, which, in turn, were closely apposed or integral with the cytoplasmic membranes in areas of cross-wall development. Chaotic morphology typifies the group. The inclusion of urinary tract infections is new in the gamut of diseases caused by CLOSPYN streptococci.
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PMID:Light-microscopic morphology, ultrastructure, culture, and relationship to disease of the nutritional and cell-wall-deficient alpha-hemolytic streptococci. 158 62

The key problems of the theory of sepsis and criteria of its postmortem diagnosis are discussed on the basis of pathological and bacteriological study of about 4000 purulent-septic diseases observed for the last 40 years in the pathology department of N. V. Sklifosovsky Moscow Research Institute of Emergency Medical Aid (sepsis after abortion, surgical and iatrogenic sepsis, acute septic endocarditis, purulent peritonitis, mediastinitis, pleuritis, phlegmons of body and limbs, bacterial shock, etc.). Sepsis, according to the author, is a generalized infectious disease developing acyclically, produced mainly by purulent coccal flora and having the course of septicopyemia. A metastatic purulent focus is an obligatory sign of the generalization. Septicemia is a local inflammatory process produced mainly by bacterial gram-negative flora. It can be a prologue of sepsis but more frequently develops in two directions: 1) purulent-resorptive fever with an acute, subacute and chronic course; 2) bacterial shock with a fulminant course and high lethality.
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PMID:[Pathology and pathogenesis of sepsis]. 159 92

A successful repair of infective endocarditis of the tricuspid valve in a drug abuser is reported. A 25-year-old woman with a history of drug addiction was referred to our hospital complaining of high fever despite antibiotic therapy. Blood cultures showed staphylococcal septicemia, and echocardiography revealed large vegetations attached to the tricuspid annulus and massive regurgitation of the tricuspid valve. Blood studies showed renal failure and hematological abnormalities due to septicemia and right ventricular failure. Excision of the vegetation and the posterior leaflet was performed along with annuloplasty (Kay's procedure). The patient's postoperative course was uneventful and subsequent echocardiographic examination disclosed no evidence of recurrence, and insignificant tricuspid valvular regurgitation. Local excision of vegetation and leaflet repair by annuloplasty may be performed in cases with well-circumscribed vegetation and minor leaflet damage.
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PMID:[A case of infective endocarditis of the tricuspid valve repaired by vegetectomy and annuloplasty]. 163 50


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