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

Epiglottitis in pediatric patients is an infection caused by Haemophilus influenzae type b, which can lead rapidly to sepsis and an asphyxial death. In an effort to study the cause and clinical course of adult epiglottitis, eight serially hospitalized adult patients with supraglottitis over a ten-month period were prospectively evaluated, including a daily laryngeal examination. Although multiple anatomic sites in the larynx and oropharynx were inflamed, the epiglottis was often not the most involved area and was actually normal in one patient. Bacterial cultures were harvested from blood, the nasopharynx, the oropharynx, and the vallecula in all patients and the preepiglottic space in two patients. In no case was H influenzae demonstrated. No patient developed respiratory compromise. It was concluded that epiglottitis is an inaccurate description of this disorder and that this non-H influenzae adult variety of supraglottitis seemingly can follow a less pernicious course than the classically described infection.
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PMID:Adult supraglottitis. A prospective analysis. 333 78

Ceftriaxone treatment (50 to 80 mg/kg once daily) was given to 201 children between 1 month and 18 years of age. There were 201 serious bacterial infections, including epiglottitis, pneumonia, cellulitis, osteomyelitis, septic arthritis, pyelonephritis, sepsis, and meningitis. The common pathogens responsible for pediatric infections isolated from these patients included Haemophilus influenzae, Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, and Escherichia coli. The overall clinic cure rate was 94%. Ten patients were clinically improved but not cured. There were two clinical failures. Bacteriologic failure occurred in six patients. The overall bacteriologic cure rate was 97%. Twenty patients (10%) experienced adverse effects; none required discontinuation of therapy. The efficacy, safety, spectrum, and convenience of ceftriaxone monotherapy make this antimicrobial agent a candidate for the treatment of choice of selected serious pediatric infections.
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PMID:Once-daily administration of ceftriaxone for the treatment of selected serious bacterial infections in children. 340 85

From 1976 to 1985, 27 adult invasive Haemophilus infections were observed at the University Medical Center in Lausanne. Only 5 cases (19%) were caused by Haemophilus influenzae type b, while 12 cases (44%) were due to Haemophilus species other than H. influenzae. Two out of 24 strains tested were ampicillin-resistant. The infections were meningitis in 8, pneumonia in 7, endocarditis in 5, sepsis of unknown origin in 4, epiglottitis in 2, and one gynecological infection. Except for the latter three patients, each case was associated with one or more underlying conditions. Seven patients died (26%), in three of whom death was directly related to the infectious process. This report and a review of the literature show that adult invasive Haemophilus infections are not uncommon and may be serious. Associated underlying diseases and advanced age are generally present. In contrast to infections occurring in children, invasive Haemophilus infections in adults are not restricted to encapsulated Haemophilus influenzae type b strains.
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PMID:[Invasive Haemophilus infections in adults]. 349 62

Fifty-nine children were enrolled in an open trial of aztreonam, a monocyclic beta-lactam, therapy for serious gram-negative infections. Thirty-six infections were microbiologically evaluable and received five or more days of therapy. Patients' ages ranged from 3 days to 12 years, and diagnoses included pyelonephritis or cystitis (20), deep soft tissue or joint infection (seven), septicemia (four), pneumonia (three), peritonitis, and epiglottitis. Causative bacteria included Escherichia coli and other Enterobacteriaceae, Pseudomonas aeruginosa, and Haemophilus influenzae. The standard regimen was 30 mg/kg every six or eight hours intravenously. All isolates were aztreonam-susceptible and were eradicated during therapy. Two patients had microbiologic relapses: a patient with Salmonella choleraesuis meningitis who was initially treated for only ten days and a patient with E coli pyelonephritis. Clinical cure was achieved in 31 of 36 children. Pharmacokinetic studies performed in six children demonstrated no difference in serum concentrations or pharmacokinetic variables between day 1 and day 7 of therapy. Although several patients had transient eosinophilia (eight), elevated levels of aminotransferase (seven), or thrombocytosis (ten), no clinically significant adverse effects were noted. In this initial, uncontrolled study, aztreonam was effective and safe in the treatment of a variety of serious gram-negative infections in children.
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PMID:Aztreonam therapy for serious gram-negative infections in children. 376 90

208 H. influenzae (HI) strains originating from the whole of Switzerland have been analysed for capsular serotype, biotype, and susceptibility to the following antibiotics: ampicillin, chloramphenicol, tetracycline, co-trimoxazole, and ceftriaxone. Serotype b is the commonest of the encapsulated strains. Biotypes II and III (respiratory tract) and I (invasive diseases) are the biotypes most encountered. Ceftriaxone is the most active among the antibiotics tested: 0.03 microgram inhibits 100% of strains, whether penicillinase producers (PP) or not. To evaluate the rate of resistant HI in Switzerland, 1883 isolates, 206 of which originated from invasive diseases (meningitis, epiglottitis, septicemia) have been considered. The PP rate is about 4%, irrespective of the group considered. Among the isolates from the invasive diseases, 3 were resistant to chloramphenicol, and 1 to ampicillin and chloramphenicol. The value of 4% for the PP strains is not very high; however, because of its powerful antibacterial activity and its high penetration into the cerebrospinal fluid, it seems reasonable to consider the use of a third generation cephalosporin, such as ceftriaxone, for the early treatment of meningitis in infants. If such a drug is indicated as a first-choice antibiotic for this meningitis it should be confined to this use only, to avoid the emergence of resistant strains.
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PMID:[Haemophilus influenzae isolated in Switzerland: antibiotic sensitivity and biotyping]. 633 96

2379 cases of infections due to Haemophilus are reported in a one year long French multicenter study. There were 1368 low respiratory and 540 high respiratory infections, 22 epiglottitis, 86 meningitis, and 68 septicemia (bacteremia). Four hundred and one times, we considered that the bacteria was not the cause of the infection. For each type of infection, we studied the distribution according to the age, the sex and the period of the year, the eventual associations and the involved serotypes. The lethality was low (22), mainly due to a particular deficiency. At last, we compared the different methods to obtain the pathologic products from the upper bronchial tract.
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PMID:[Clinical results of a multicenter study of Haemophilus infection]. 634 49

T-1982 (cefbuperazone) was evaluated in 25 children with a suspicion of bacterial infections, of the 21 confirmed bacterial infections, 18 were shown to be effective (efficacy rate, 85.7%). The diagnosis included pneumonia (4), bronchopneumonia (3), acute bronchitis (4), acute pharyngitis (1), acute laryngitis (1), acute epiglottitis (1), acute enterocolitis (3), cervical lymphadenitis (1), acute pyelonephritis (1) and suspected septicemia (2). The etiologic pathogens recovered were Haemophilus influenzae (4), Staphylococcus aureus (2), Salmonella typhimurium (1), Salmonella subgenus (1), and enteropathogenic Escherichia coli (2). Among these strains, 7 strains were eradicated after treatment. A case of suspected septicemia and 2 cases of acute enterocolitis with Salmonella infection were not effectively treated with T-1982. The serum half-life of T-1982 was 1.2 hours after an intravenous bolus injection. No severe adverse reaction was encountered with the T-1982 therapy. The data suggest that T-1982 is an effective and safe parenteral antibiotic in the treatment of susceptible pediatric bacterial infections.
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PMID:[Clinical evaluation of T-1982 (cefbuperazone) in the pediatric infections]. 634 35

Eight episodes of clinical septicemia in five children were assessed using C-reactive protein (CRP) determinations. The measurements were performed turbidimetrically, with quantitative results available in less than 10 minutes. Three patients had epiglottitis, one had recurrent septicemia secondary to severe underlying illnesses and one patient was followed postoperatively after open heart surgery. Regardless of etiology septicemia was consistently associated with a rapid increase (greater than or equal to 20 to 214 mg/liter) in the CRP concentration. Elevated values were obtained 5, 13 and 16 hours after the onset of symptoms of epiglottitis. When determined the CRP level was invariably elevated at the time of the first positive blood culture. CRP determinations in patients with symptoms of septicemia would have supported the diagnosis at least 24 hours before the positive blood culture. In addition, sequential CRP measurements proved beneficial in monitoring the course of septicemia.
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PMID:Rapidity of C-reactive protein in detecting potential septicemia. 660 20

A total of 813 patients from the years 1976 to 1980 who had a bacteremic Haemophilus influenzae infection were analyzed. Special attention was paid to disease entities (16.5% of the total) other than meningitis (60.5%) or epiglottitis (23.0%). Ninety-six cases in the nonmeningitis, nonepiglottitis (NMNE) group showed the following distribution: 25 patients with septicemia without specific focus, 21 arthritis, 19 cellulitis, 17 pneumonia, six otitis, four local abscess, two laryngotracheobronchitis, and two with an eye infection. Eighty-eight percent of the cases were children who were less than 5 years old; in the septicemia and pneumonia groups, however, 33 percent were 15 years of age and older, and 10 percent were over 60 years of age. All diseases in the NMNE group were acute; 51 percent of the patients sought medical advice within two days. C-reactive protein (CRP) was elevated constantly at presentation, erythrocyte sedimentation rate (ESR) was increased (greater than 20 mm/hr) in 87 percent, high fever greater than 38.5 degrees C (101.3 degrees F) was measured in 85 percent, and leukocytosis (greater than 15 X 10(9)/l) was present in 71 percent. Various antimicrobial agents were given for an average of 17 days. The mean period of hospitalization was 13 days. Case fatality rate was 4 percent; all deaths occurred among patients with an underlying disease. No permanent damage was observed.
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PMID:Systemic Haemophilus influenzae infection in Finland. 670 35

Levels of antibodies to the capsular polysaccharides of groups A and C Neisseria meningitidis and Haemophilus influenzae type b were determined by radioimmunoassay in acute- and convalescent-phase sera of 377 patients with meningitis, septicemia, or epiglottitis. Diagnostic criteria, based on a fourfold or greater rise in antibody level and/or a high specific antibody level, correctly identified 85% of group A meningococcal diseases, 90% of group C meningococcal diseases, and 78% of H. influenzae type b diseases in children older than but only 15% in infants younger than 1.5 years of age. When levels of antibody in acute-phase sera were high, they were predominantly of the IgA class. A greater than fourfold rise in levels of antibodies to group A meningococcus was seen in 10%-32% of persons with disease caused by other bacteria, but minimal false-positive reactions occurred with group C meningococcus or H. influenzae type b.
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PMID:Antibody response to capsular polysaccharides of groups A and C neisseria meningitidis and Haemophilus influenzae type b during bacteremic disease. 678 3


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