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

Streptococci are amont the most common bacterial pathogens physicians encounter in practice. Infections with streptococci continue to occur with significant frequency despite the general sensitivity of these organisms to a variety of widely used antibiotics. In newborn infants and other special patient groups, streptococci may produce fulminant and fatal sepsis (Table 1). In normal children and adults, infections usually are short term and often mild or unrecognized but with the possibility of resulting, unpredictably, in nonsuppurative complications some weeks or months later. Although scarlet fever has become an unusual and clinically attenuated disease, its rashless analog, streptococcal pharyngitis, presents thorny problems in the differential diagnosis of symptomatic patients and in the detection of subclinical infections. Erysipelas now is a rare disease, but recent studies have confirmed that streptococci often are the primary etiologic agent in impetigo, another type of skin infection--with peculiar bacteriologic and epidemiologic features. Infections with group D streptococci have always been a special case because of their frequent resistance to penicillin, and group B streptococci (also somewhat resistant) present special problems in the perinatal period. Streptococci may appear in unexpected places or guises (see Table 1). Thus, the modern physician has little reason to relax in his vigilance for and knowledge of streptococcal infections.
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PMID:Streptococcal infections--updated. 81 Mar 36

A study was carried out to determine whether the preexisting decline in mortality rates from infectious diseases accelerated after the introduction of antibiotic and chemotherapeutic drugs. Linear regression curves showed that in Sweden mortality rates declined faster in septicemia, syphilis, and non-memingococcal meningitis after the introduction of these drugs. By contrast, for the ten other infectious diseases studied, (scarlet fever, erysipelas, acute rheumatic fever, puerperal sepsis, meningococcal infection, bronchitis, pneumonia, tuberculosis, typhoid fever, and acute gastroenteritis) no such accelerated decline in mortality could be detected. The findings suggest that antibiotic and chemotherapeutic drugs have not had the dramatic effect of the mortality of infectious diseases popularly attributed to them.
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PMID:The effect of antibiotics on mortality from infectious diseases in Sweden and Finland. 100 14

245 strains of hemolytic streptococci, isolated from 225 patients with infectious diseasses, were grouped serologically according to Lancefield. About 40% belonged to group B and half of them were found in the genito-urinary tract. Another 40% belonged to the groups C and G, half of them being found in the respiratory tract and often as the only potentially pathogenic organism. About 10% of the isolates belonged to other of the groups E to T, including M streptococci, and were found under similar circumstances as the C and G isolates. The last 10% could not be referred to any of the groups A-U. In 4 cases group B streptococci were found as the only potentially pathogenic organism in typical erysipelas, and in 4 cases of septicemia the only bacterial finding from blood was a streptococcus of the groups B, C or G. In these cases, as in most others in which an etiological significance could be ascribed to steptococci of other groups than A, the patient was in a bad general condition, due to very high age, agranulocytosis, ethylism or narcomania.
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PMID:Occurrence and significance of hemolytic streptococci groups b-u in human infectious disease. 114 31

Groups A, B, C and G streptococci were cultured from 63 consecutive in-patients recruited between November 1987 and April 1988 and monitored until the end of July 1988. Chronic leg ulcers were present in 34 patients. Group G was found in 34 patients, 25 of whom had pyoderma and 3 had sepsis. Six of the patients had no signs of clinical infection, and treatment with antibiotics was therefore withheld. Recurrent phlegmon or erysipelas developed in 2 of 28 patients with clinical Group G infections. Erysipelas developed some 1-7 months later in 3 of the 6 patients who were not initially treated. No significant difference in severity or additional medical conditions was found between the patients with either Group G or Group A streptococci. In comparison, data on all streptococcal cultures at the Department indicated that Group G was isolated 2.6 times as often as Group A streptococci for the in-patients, compared with 1.1 for all patients seen. It is concluded that Group G streptococcal skin infections must be regarded with the same clinical vigilance as Group A infections.
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PMID:Group G streptococcal infections on a dermatological ward. 135 Mar 98

Three cases are reported of hypogammaglobulinemic males with recurrent Campylobacter jejuni septicemia and erysipelas-like cellulitis without diarrhoea. In one patient Campylobacter jejuni grew from skin biopsy specimens. The findings in another patient were strongly suggestive of osteomyelitis caused by Campylobacter jejuni. Since the susceptibility of hypogammaglobulinemic patients to infection with Campylobacter jejuni is probably related to a lack of serum bactericidal activity against Campylobacter jejuni due to lack of IgM, two patients in whom previous antimicrobial treatment failed were treated with plasma infusions. This regimen supplemented with imipenem resulted in cure of these relapsing infections. Campylobacter jejuni septicemia must be considered in hypogammaglobulinemic patients who present with periodic fever and cellulitis.
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PMID:Erysipelas-like skin lesions associated with Campylobacter jejuni septicemia in patients with hypogammaglobulinemia. 146 26

Four patients with acute paracoccidioidomycosis, hypoalbuminemia, ascites and associated infections are reported. They have been admitted to hospital 35 times, 4 of them due to active paracoccidioidomycosis, 14 to associated infections, 14 to ascites, edema and diarrhoea and 3 to herniorrhaphy. Two of them recovered after sepsis and central nervous system, muscular and subcutaneous cryptococcosis. The remaining two died. One had infectious diarrhoea (S. flexneri), peritoneal tuberculosis and sepsis (S. epidermidis); the other had bacterial meningitis, erysipelas, beta-hemolytic Streptococcus sepsis and miliary tuberculosis. Their immunodeficiency was attributed to enteric protein loss and/or malabsorption and malnutrition and was recognized by reduced response to delayed hypersensitivity skin tests in four patients and hypogammaglobulinemia in three of them. The authors discuss the need for prospective studies to be carried out, aiming at the mechanisms involved in secondary infections. Alternatives for maintaining the patients' adequate nutritional state should be investigated, to guarantee proper immune response and thus the ability to control intervening infections in patients with juvenile paracoccidioidomycosis.
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PMID:Immunodeficiency secondary to juvenile paracoccidioidomycosis: associated infections. 148 Feb 6

The diagnosis of erysipelas is usually made clinically. Features that help distinguish erysipelas are acute onset, erythema, warmth, edema, pain, fever, and isolated regional involvement with clearly demarcated margins. High ASO titers and response to penicillin therapy are reassuring. Simple uncomplicated erysipelas or cellulitis in adults can usually be treated on an outpatient basis. Extensive facial involvement with fever and a toxic appearance warrants hospitalization. Facial cellulitis or erysipelas in children, unless quite limited, requires hospitalization because of the high risk of Hemophilus influenzae infection and sepsis. Hospitalized patients should show visible signs of resolution and be afebrile for at least 24 hours prior to discharge. They should be maintained on oral antibiotic therapy at home for an additional 7 to 10 days.
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PMID:Facial erysipelas: report of a case and review of the literature. 189 May 24

The level of plasma fibronectin was measured to 20 patients suffering from erysipelas and 10 normal controls. Significantly low levels of plasma fibronectin were detected in the group of patients (134 +/- 7.4 g./ml) in comparison to the normal control group (352.6 +/- 42.9 g./ml) p less than 0.001. This could be of prognostic value and also of therapeutic one. Some centres have tried fibronectin replacement therapy in the treatment of critically ill patients with severe bacterial sepsis.
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PMID:Plasma fibronectin level in erysipelas. 213 94

The infection with Erysipelas rhusiopathiae demonstrates that it is possible to characterize the significance of predisposing factors. The virulence of the agent is most important among the exogenous factors; it determines decisively the course of the disease: 1. paracute course as septicemia; 2. chronic course as polyarthritis; 3. subclinical course nearly without any symptoms. The immune status and the genotype of the host are predominant out of endogenous factors. The importance of immunity is known since a long time. A series of field observations supported the potential genetical influence in the pig. Within the hereditability an association to the MHC (in special genetic lines of rats to the RT 1 system of the MHC) was most recently determined in inbred laboratory animals. Additionally several environmental conditions, which can be summarized as stress, and as endogenous factor the age of the animals are relevant for the pathogenesis of the erysipelas infection. A non variable but most important disposition for special tissues are the so-called "borderline tissues", where accumulation, sedimentation and persistence of bacterial antigens are wellknown as described earlier. This phenomenon is determined by hemodynamic manifestation and quantifiably regulated by cytokines especially interleukin (IL 1) as well as by the tumor necrosis factor (TNF alpha) and prostaglandin PgE2. Additionally the cross reactivity of antibodies of Erysipelas rhusiopathiae against most specific collagen of type II, IX and XI in the pig and in laboratory animals was elaborated. This autoimmune phenomenon called "immunologic mimicry" supports besides the special physiologic conditions as niche of defense a very successful evolutionary adaptation of the agent.
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PMID:[Erysipelas as a disease factor]. 268 51

Trace elements like copper, zinc, iron and selenium have a significant influence on the function of the immune system. We studied plasma levels of trace elements in 53 patients with acute bacterial and viral infections. In bacterial infections (septicaemia, pneumonia, erysipelas and meningitis) the plasma concentrations of selenium, iron and zinc were decreased. Plasma copper was unchanged in patients with erysipelas, but increased in other types of bacterial infections. Although the patients with viral infections showed similar shifts of the trace elements as were observed in patients with bacterial infections, the changes were not as pronounced. A plasma selenium value below 0.8 mumol/l was found in only 6% of the patients with viral infections in contrast to 63% of the patients with septicaemia or 57% of the patients with pneumonia. Furthermore, in viral infections 60% of the zinc values were below the mean level of 12.8 mumol/l observed in healthy controls as compared with 90% of the values in patients with sepsis or 92% of the values in patients with pneumonia. The onset of change in trace elements occurred within a few days and persisted for several weeks. These changes seem to be non-specific and are independent of the agent causing infection. The different types of infections were followed by changes in most of the plasma proteins which are known to be associated with an inflammatory reaction. The changes in plasma proteins were most pronounced in patients with sepsis and pneumonia. Patients with sepsis having a high degree of inflammation did not show a positive correlation between the severity of the disease--as judged by plasma proteins--and the alterations of trace elements.
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PMID:Trace element alterations in infectious diseases. 321 52


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