Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Orthotopic cardiac transplantation has become established for selected infants with severe forms of congenital heart disease. This study reviews the combined experience and intermediate term results of infants undergoing orthotopic cardiac transplantation from Children's Memorial Hospital, Chicago, and Kosair Children's Hospital, Louisville. From June 1986 through December 1989, 20 orthotopic cardiac transplantations were performed in 19 patients. Sixteen patients had variants of hypoplastic left heart syndrome. One infant had anomalous origin of the left coronary artery with severe ischemic cardiomyopathy. Two infants had aortic stenosis with endocardial fibroelastosis, and one had extracorporeal membrane oxygenation as a bridge to transplantation. Immunosuppression included cyclosporine, azathioprine (Imuran), and corticosteroids with an effort to wean the patients from steroids by 6 months to 2 years. Three early deaths resulted--from technical errors in two patients and from hyperacute rejection in one patient at 3 days. Four late deaths have occurred. Two patients died at 2 and 13 months of acute rejection. One patient died at 15 months of acute rejection after retransplantation. One patient died at 7 months of respiratory syncytial viral pneumonia. The remaining 12 patients are surviving 5 to 47 months (means 20 months) after orthotopic cardiac transplantation. Rejection surveillance in the first 6 months is by clinical signs supplemented by echocardiography, electrocardiography, and cell cycle analysis; endomyocardial biopsy is used after 6 months of age. For the cumulative series, 24 episodes of suspected rejection have been treated during 277 at-risk patient months with intravenous methylprednisolone (Solu-Medrol) (n = 18) and monoclonal antibody (OKT3) (n = 6), for an incidence of 1.04 episodes of rejection per patient per year. Serious posttransplantation infections including endocarditis, catheter sepsis, meningitis, and colonic perforation were successfully treated in four patients. Subjectively, their quality of life is excellent as shown by normal growth and developmental milestones and a low hospital readmission rate (1.4 episodes per patient per year). These encouraging intermediate term results warrant continued application of infant orthotopic cardiac transplantation for severe forms of congenital heart disease.
 ...
PMID:Intermediate term results of infant orthotopic cardiac transplantation from two centers. 190 39

A 59-year-old chronic alcoholic male, with no cardiac past history, was hospitalised with septicemia 5 months after the endoscopic removal of 2 benign intestinal polyps. The diagnosis of tricuspid endocarditis was possible only 2 months later on the basis of echocardiography requested because of the onset of a tricuspid systolic murmur. Blood cultures revealed the presence in succession of streptococcus D fecalis then bovis. Antibiotics, changed several times because of the onset of complications (allergy, agranulocytosis), failed to deal with the problem of infection as shown by the development of several septic pulmonary emboli which finally resulted in total tricuspidectomy with neither immediate nor secondary valve replacement. The authors use this clinical case to review the characteristics of tricuspid endocarditis, the incidence of which is on the increase in certain etiological contexts (staphylococcal endocarditis in drug addicts or secondary to central vascular lines). They stress that the clinical picture is often confusing since the murmur of tricuspid incompetence is absent in 2/3 of cases. Echocardiography must therefore be requested routinely in all septicemias, thus enabling earlier diagnosis and assessment of the risk of pulmonary embolism (risk if vegetation greater than 10 mm). The nature of the organism responsible may be suggestive of certain etiologies. Thus malignant disease of the colon should be sought if the bacterium is a streptococcus D bovis. Apart from antibiotics, treatment must include effective anticoagulation to decrease the risk of embolic recurrence.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Isolated tricuspid endocarditis. Apropos of a case caused by Streptococcus D bovis and faecalis occurring after coloscopy]. 190 45

Operations were conducted for the second time on 87 patients (98 operations). Reoperations were performed on 75 (76.5%) and closure of the fistula in 23 (23.5%) patients. The outcome of the operation was appraised according to the clinical course: without sepsis and with prosthetic septic endocarditis, respectively, in 57 (65.5%) and 30 (34.5%) cases. It was found that survival was lower among patients with prosthetic septic endocarditis than among those without sepsis, 37.9% and 53%, respectively. The position of the prosthesis determined the time of the development of the complication, both in fistulas and in thromboses. Disturbances in the function of the prosthesis occur mainly in the first postoperative months in patients without sepsis and in the first months and the late-term periods after surgery in patients with prosthetic septic endocarditis.
 ...
PMID:[Outcomes of reoperations in dysfunction of mechanical prostheses in relation to the clinical course]. 191 Sep

Many kinds of microorganisms can produce toxic septicemia in immunocompromised hosts. We are reporting alpha-hemolytic streptococcal septicemia and meningitis in two children with hematological malignancies. [Case 1] 6 year old girl who had been suffering from acute lymphocytic leukemia. She had sepsis and bacterial meningitis in maintenance-therapy for leukemia. Streptococcus sanguis was isolated from the blood and cerebrospinal fluid (CSF). [Case 2] 11 year old girl who had had malignant lymphoma (non-Hodgkin type). She also had sepsis and bacterial meningitis due to Streptococcus mitis which was isolated from blood and CSF in maintenance-therapy. Both cases had been treated with anti-cancer drugs and had severe granulocytopenia. Positive rate of blood cultures during the recent 6 years (1984.1-1989.12) at our department was 6.0% (total number of cultures were 2,019, positive cultures were 121). Strains of 131 bacteria were determined; Gram-positive cocci were 70 strains (53.4%) and Gram-negative rods were 52 strains (39.7%). Fifteen strains (11.5%) of alpha-hemolytic Streptococci were isolated during 6 years. One hundred thirteen cases of septicemia were analysed in medical charts and 12 cases of alpha-hemolytic streptococcal septicemia were observed (5 cases with infective endocarditis and 7 cases in immunocompromised states).
 ...
PMID:[Alpha-hemolytic streptococcal septicemia and meningitis in immunocompromised children]. 191 21

In the past decade, Corynebacterium JK has emerged as a pathogen in several distinct clinical settings, including sepsis in immunocompromised patients and prosthetic valve endocarditis. It is also recognized as a nosocomial pathogen in infections of prosthetic devices. We present a case of a patient with carcinomatous meningitis who developed a Corynebacterium JK infection of an internal ventriculostomy which was used for intraventricular chemotherapy. Treatment with systemic and intraventriculostomy vancomycin for three weeks resulted in bacteriologic resolution of the infection. Removal of the prosthetic device was not essential for cure in this patient. The clinical spectrum of infection with this organism and aspects of therapy are reviewed. As a greater awareness of the pathogenic nature of this organism develops, it is likely to be implicated as a causative agent in a variety of infections.
 ...
PMID:Corynebacterium JK: a new pathogen in ventriculostomy infections. 191 48

Fifty-two patients with moderate or severe infections associated with internal medicine were treated with imipenem/cilastatin sodium (IPM/CS) and the efficacy and the safety of this drug were evaluated. There were 20 patients with pneumonia, 10 with acute exacerbation of chronic respiratory tract infections, 9 with sepsis, 2 with pyothorax, 3 with intraabdominal infection, 2 with urinary tract infection, 1 with pulmonary abscess, 1 with infective endocarditis, 4 with fever of unknown origin. Forty-four patients were evaluable for the efficacy. Clinical efficacies were excellent in 12 patients, good in 26, fair in 3 and poor in 3. The overall clinical efficacy was 86.4%. The efficacy rate was 63.6% in patients previously treated and 93.9% in patients previously untreated with other antibiotics. Bacteriologically, Staphylococcus aureus (8 strains), Streptococcus pneumoniae (5), Streptococcus pyogenes (1), other Gram-positive coccus (1), Klebsiella pneumoniae (8), Haemophilus influenzae (4), Pseudomonas aeruginosa (3), Serratia marcescens (3), Escherichia coli (3), Branhamella catarrhalis (1), Citrobacter freundii (1), Klebsiella oxytoca (1), Enterobacter sp. (1), and Peptostreptococcus sp. (1) were eradicated. P. aeruginosa (3) and Acinetobacter sp. (1) decreased. S. aureus (1), S. epidermidis (1), P. aeruginosa (5), and S. marcescens (1) persisted or appeared. The eradication rate was 83.7%. Six patients showed adverse reactions including general fatigue 1, epigastralgia 1, eruption 1, eosinophilia 1 and elevation of S-GOT 2. But all of the adverse reactions were mild or slight, and transient. These findings indicate that IPM/CS is a useful and safe drug against bacterial infections in internal medicine.
 ...
PMID:[Clinical evaluation of imipenem/cilastatin sodium in the internal medicine]. 192 Aug 13

We review the syndrome of Capnocytophaga canimorsus (DF-2) septicemia after exposure to dogs or cats. We describe a previously healthy patient who developed diffuse intravascular coagulation and symmetrical peripheral gangrene as a result of C. canimorsus septicemia after a dog bite. To our knowledge, this patient was the first to receive combined plasmapheresis and leukapheresis for C. canimorsus septicemia. Symmetrical peripheral gangrene is frequently associated with C. canimorsus septicemia and may lead to an early diagnosis in patients who become severely ill after a dog bite. Other complications include arthritis, meningitis, and endocarditis. These manifestations can also be found in previously healthy patients, although a prior splenectomy or other causes of impaired host defense clearly enhance the risk. Prompt treatment with penicillin G is required.
 ...
PMID:Purpura fulminans and symmetrical peripheral gangrene caused by Capnocytophaga canimorsus (formerly DF-2) septicemia--a complication of dog bite. 192 3

A case of facial cellulitis complicated by regional thrombophlebitis and septicemia is reported in a 6 year-old girl. Streptococcus sanguis, a bacterial agent, unusually responsible for cellulitis, was isolated from 5 blood cultures. This child had no immunosuppression or endocarditis or dental infection. She had been previously given a non-steroidal anti-inflammatory agent, which was potentially responsible for the diffusion of infection.
 ...
PMID:[Palpebral edema with fever and Streptococcus sanguis septicemia]. 192 50

Anterior segment necrosis following ocular infections and endophthalmitis secondary to group C streptococcal infection are both rare. We report a case of unilateral anterior segment necrosis associated with bilateral metastatic group C streptococcal endophthalmitis in a 68-year-old black man with multiple systemic disorders complicated by culture-confirmed group C streptococcal septicemia and endocarditis. Pathological examination of the left eye at autopsy demonstrated necrosis of the anterior segment involving the cornea, iris, lens and ciliary body. The right eye showed signs of mild residual inflammation. To our knowledge anterior segment necrosis has not previously been described in association with group C streptococcal endophthalmitis.
 ...
PMID:Anterior segment necrosis associated with endogenous endophthalmitis secondary to group C streptococcal septicemia. 193 69

A 60-year-old female with mitral stenosis developed prosthetic valve endocarditis due to methicillin resistant staphylococcus aureus septicemia 3 weeks after mitral valve replacement. In vitro test disclosed susceptibility to minocycline and clindamycin. Despite large amount of intravenous administration, progressive heart failure due to massive perivalvular leakage occurred as a consequence of persisting infection. An emergent operation revealed valve detachment of the posterior portion resulting from ring abscess formation. A mitral prosthesis with a Gore-Tex flange was implanted partially in the left atrium just above the mitral ring and sutured to the atrial wall. Postoperative relapse was not detected even after discontinuing antibiotics. Prosthetic valve endocarditis due to methicillin resistant staphylococcus aureus is highly resistant to antibiotic therapy and likely to develop valve ring abscess. Prompt surgical treatment is mandatory in this situation.
 ...
PMID:[A case report of early prosthetic valve endocarditis due to methicillin resistant Staphylococcus aureus infection--an experience of intraatrial implantation of mitral prosthesis with a Gore-Tex flange]. 196 Apr 64


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>