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)

A 54-year-old woman was diagnosed as having septicemia secondary to infective endocarditis with aortic regurgitation which was complicated by endophthalmitis. Her septicemia was controlled by intravenous antibiotic therapy. Then the localized eye infection and the aortic regurgitation with a massive vegetation were surgically treated simultaneously. She had no relapse of infection after intensive postoperative antibiotic therapy.
 ...
PMID:Simultaneous surgery for infective endocarditis and endophthalmitis. 1035 Jan 8

Clinical charts of 2,398 consecutive HIV-infected patients hospitalized over an 8-year period were reviewed retrospectively to identify all cases of Serratia infection and to evaluate the occurrence and outcome of these cases according to several epidemiological. clinical, and laboratory parameters. Seventeen of 2,398 (0.71%) patients developed Serratia marcescens infections: nine had septicaemia, six had pneumonia, one had a lymph node abscess, and one had cellulitis. All patients were severely immunocompromised, as evidenced by a mean CD4+ lymphocyte count of < 70 cells/microl and a frequent diagnosis of AIDS (13 patients). When compared with other disease localizations, septicaemia was related to a significantly lower CD4+ cell count and a more frequent occurrence of neutropaenia. Antibiotic, corticosteroid, or cotrimoxazole treatment was frequently carried out during the month preceding disease onset. Hospital-acquired Serratia spp. infection was more frequent than community-acquired infection and was significantly related to AIDS, neutropaenia, and sepsis. Antimicrobial sensitivity testing showed complete resistance to ampicillin and cephalothin but elevated susceptibility to ureidopenicillins, second- and third-generation cephalosporins, aminoglycosides, quinolones, and cotrimoxazole. An appropriate antimicrobial treatment attained clinical and microbiological cure in all cases, in absence of related mortality or relapses. Since only 13 episodes of HIV-associated Serratia spp. infection have been described until now in nine different reports (7 patients with pneumonia, 3 with sepsis, 1 with endophthalmitis, 1 with perifolliculitis, and 1 with cholecystitis), our series represents the largest one dealing with Serratia marcescens infection during HIV disease. Serratia marcescens may be responsible for appreciable morbidity among patients with HIV disease, especially when a low CD4 + cell count, neutropaenia, and hospitalization are present. The clinician and the microbiologist facing a severely immunocompromised HIV-infected patient with a suspected bacterial disease should consider the Serratia spp. organisms. In fact, a rapid diagnosis and an adequate and timely treatment can avoid disease relapses and mortality.
 ...
PMID:Clinical and microbiological survey of Serratia marcescens infection during HIV disease. 1083 12

A young alcoholic and heavy smoker was admitted because of Klebsiella pneumoniae bacteremia. The abdominal and pelvic computed tomography with enhancement revealed an abscess in the right prostate. He experienced blurred vision of his left eye on the third day during admission. Initial ocular examination revealed mild reaction in the anterior chamber and vitreous as well as multiple Roth's spots in the retina. The administration of empirical antibiotics including cefazolin and gentamicin intravenously was changed to ceftriaxone and amikacin after ophthalmologic consultation. After parenteral antibiotics for 3 weeks, the systemic condition was controlled, and the vision remained stable. During the past decades, many cases of endogenous Klebsiella pneumoniae endophthalmitis associated with liver abscess were reported in Taiwan. However, documented reports of this condition associated with a prostate abscess are rare. This case, classified as posterior focal endogenous endophthalmitis, had good prognosis under appropriate antibiotic treatment. Early diagnosis and prompt therapy are important for control of sepsis and restoration of vision.
 ...
PMID:Endogenous Klebsiella pneumoniae endophthalmitis associated with prostate abscess: case report. 1090 31

Metastatic meningococcal endophthalmitis, although rare, is a rapidly progressive and sight-threatening infection. We present a 10-month-old infant with meningococcal meningitis who developed unilateral metastatic endophthalmitis. If patients develop a sepsis-like picture with cloudy cornea and purulent conjunctivitis, we have to consider the possibility of endophthalmitis and full ophthalmological evaluations are indicated. Treatment should be started as early as possible. The outcome of endophthalmitis is frequently permanent visual impairment. Endophthalmitis is a true medical emergency requiring early antibiotic therapy with full dose of antimicrobials to avoid morbidity and blindness.
 ...
PMID:Endophthalmitis as a complication of meningococcal meningitis: report of one case. 1091 May 99

Oxidative damage plays a key role in septic shock induced by the endotoxin lipopolysaccaride (LPS) by enhancing the formation of reactive oxygen species such as superoxide anion radicals, peroxides, and their secondary product, malondialdehyde, especially in the liver. In this study, histopathologic changes in several organs were compared among groups of male Wistar rats that had been injected with LPS following prophylactic pretreatment with either of 2 antioxidants, a group that had been injected with LPS without pretreatment with antioxidants, an untreated control group, and groups that had been injected with either of the 2 antioxidants only. The antioxidants used were a water-soluble natural antioxidant from spinach (NAO) and the NADPH oxidase inhibitor apocynin. Hematoxylin-and-eosin-stained slides were prepared, and lesions were semiquantitatively scored. Exposure to LPS alone was associated with multifocal hepatocellular necrosis and acute inflammation, thymic and splenic lymphoid necrosis, ocular retinal hemorrhage and acute endophthalmitis, adrenal medullary vacuolation and necrosis and acute inflammation, and decreased adrenal cortical cytoplasmic vacuolation (consistent with depletion of steroidal hormone contents). Results indicated that pretreatment with both antioxidants for 8 days reduced, in some organs, the necrotic and inflammatory changes associated with the LPS challenge. These findings suggest a potential therapeutic application for these antioxidants in clinical sepsis.
 ...
PMID:Effects of antioxidants apocynin and the natural water-soluble antioxidant from spinach on cellular damage induced by lipopolysaccaride in the rat. 1093 46

Access-related infections are the most important causes of the loss of vascular access for dialysis. These infections also may lead to devastating consequences, including sepsis with multiorgan failure; endocarditis; or metastatic infections such as vertebral osteomyelitis, epidural abscess, or endophthalmitis. A small percentage of these complications are fatal; overall, dialysis-related bloodstream infections are the second leading cause of death in patients undergoing hemodialysis, accounting for up to 10% of all deaths, and approximately three-fourths of all deaths caused by infection in patients undergoing dialysis. Moreover, vascular placement and complications account for approximately one fourth of all admissions and hospital days among patients on dialysis.
 ...
PMID:Vascular access infections in patients undergoing dialysis with special emphasis on the role and treatment of Staphylococcus aureus. 1157 Jan 39

We describe the case of a patient who developed neutropenia associated with sepsis and endophthalmitis after ticlopidine therapy for coronary stenting. The neutropenia did not resolve until granulocyte colony stimulating factor (G-CSF) was given. This uncommon case brings to attention the need for the immediate use of G-CSF in patients with delayed recovery from drug-related neutropenia and severe infection.
 ...
PMID:Granulocyte colony stimulating factor treatment for delayed recovery of ticlopidine-related neutropenia. 1183 43

Metastatic or endogenous endophthalmitis (EE) is a serious consequence of systemic sepsis. It is defined as intraocular infection resulting from haematogenous spread of organisms in which the initial focus of infection is at a site distal to the eye. A red/sore eye in a patient with a known septic focus needs urgent attention as EE can be a major cause of visual loss. Early diagnosis and treatment are associated with better visual outcome. This article focuses on the two main causes of EE, namely bacterial and fungal infections, and also briefly mentions dissemination of cytomegalovirus to the eye in immunocompromised patients. Although conscious patients may notice an ocular problem, unconscious or very sick patients may not; vigilance by medical staff in looking for early signs of this is extremely important.
 ...
PMID:The eye in systemic sepsis. 1244 93

Endogenous endophthalmitis is a rare, but devastating complication of septicemia. The prognosis of maintaining visual acuity in patients with septic endophthalmitis is poor in spite of an early diagnosis and the timely start of conventional therapeutic procedures because the intravitreous drug concentration remains low after the systemic administration of antibiotics due to the blood-ocular barrier. We treated an elderly female patient with endogenous endophthalmitis complicated with disseminated intravascular coagulation associated with a Klebsiella pneumoniae liver abscess. Endophthalmitis developed rapidly and we thus had to perform an enucleation of both eyeballs even though we made an early diagnosis and performed liver abscess drainage as well as the prompt systemic and subconjunctival administration of antibiotics. Our experience in treating this case emphasizes the need to perform the timely intravitreous infusion of antibiotics with a support therapy consisting of the systemic and subconjunctival administration of antibiotics for endogenous endophthalmitis associated with a Klebsiella pneumoniae liver abscess.
 ...
PMID:Endophthalmitis with Klebsiella pneumoniae liver abscess. 1272 45

Invasive bacterial and candidal infections are known to involve the retina, but the natural history of the retinal lesions and the utility of ophthalmologic consultation in the critical care setting as a diagnostic tool are not well understood. We 1) performed weekly funduscopic examinations on 77 medical and surgical patients in intensive care units (ICUs), 2) analyzed results of serial ocular examinations in 180 non-neutropenic patients with candidemia, and 3) reviewed the English literature on the association of retinal lesions with disseminated bacterial or candidal infection (DBCI). We found that 15 (19%) of the ICU patients had retinal lesions consistent with DBCI. Of these 15, 1 had clearly sepsis-related retinal lesions, while 13 (87%) had 1 or more systemic disease that could have explained their retinal findings (6 diabetic retinopathy; 2 human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) retinopathy; 2 hypertensive retinopathy; 1 hemolytic uremic syndrome, and 1 leukemia). Multivariate analysis revealed that systemic disease (odds ratio 8.37, 95% confidence intervals: 3.24-21.56) independently correlated with the presence of retinal lesions while DBCI, trauma, hyperalimentation, and transfusion of blood products were not independently predictive in any analysis. Twenty of the 180 (15%) candidemic patients had retinal lesions. Two (1%) had classic 3-dimensional white lesions with vitreal extension, and 5 (2.7%) had chorioretinal lesions without vitreal haziness. Notably, 10% of patients had superficial retinal hemorrhages and/or cotton wool spots that could have been due to either candidemia or a systemic disease (diabetes, hypertension, renal failure, closed head trauma). Concurrent bacteremia occurred in 3 of the 27 patients with eye lesions. Retinal lesions resolved in a mean of 33 days. None of the patients had symptoms at the time of the retinal finding. We found 3 studies that prospectively assessed retinal lesions in bacteremic patients. The frequency of retinal lesions in these series varied from 12% to 26%, with the most common lesions being cotton wool spots followed by superficial retinal hemorrhages. White-centered hemorrhages were seen in about 15% +/- 2 of bacteremic patients. Five studies prospectively evaluated candidemic patients for Candida endophthalmitis. These studies observed rates from 0% to 78% for lesions consistent with candidal endophthalmitis. Most studies performed recently found that nonspecific lesions such as cotton wool spots or superficial retinal hemorrhages occurred with a frequency of 11% to 20%. The availability of less toxic antifungal agents, more frequent use of empirical therapy, and the trend to early treatment may be altering the frequency of this complication. Observation of a classic 3-dimensional retina-based vitreal inflammatory process is virtually diagnostic of endogenous endophthalmitis due to Candida spp., but such lesions are relatively uncommon. Conversely, nonspecific lesions that could be due to bacterial or candidal endophthalmitis (cotton wool spots, retinal hemorrhages, and Roth spots) are seen frequently. These lesions are most often due to an underlying systemic disease rather than an infection. Serial examinations provide the best evidence that a given lesion is due to an intercurrent infection. The current low rate of vitreal extension of retinal process appears to be due to the high rate of empirical or therapeutic use of antifungal agents in high-risk patient groups. Ophthalmoscopy should be performed in patients with known candidemia. However, ophthalmoscopic examination seems to have little value in assisting with the discovery of occult disseminated candidiasis or bacterial infection.
 ...
PMID:Retinal lesions as clues to disseminated bacterial and candidal infections: frequency, natural history, and etiology. 1279 5


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