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

From 1976 to 1981, 25 cases of S. pyogenes septicemia were diagnosed at the University Medical Center, Lausanne, Switzerland, in 5 children and 20 adults. The twenty adult patients are described. The age range was from 24 to 94 years. The portal of entry was the skin (erysipelas, skin ulcers, surgical wounds) in 12 cases, the respiratory tract (upper 3, lower 3) in 6 cases, and the vagina in 2 cases. All except 3 patients were acutely ill with high temperature (39 degrees C) and toxic appearance. None had an underlying malignancy. The clinical course was complicated in 5 patients, i.e. septic arthritis (2), pulmonary abscess (1), endocarditis (1) and acute rheumatic fever (1). After initiation of penicillin therapy, temperature and symptoms resolved only slowly (mean 11 days). Four patients died from infection. In 2 of them the antibiotic treatment had been delayed. When a patient exhibits clinical signs of septicemia and muco-cutaneous lesions suggestive of a portal of entry, S. pyogenes septicemia should be suspected. Complications are frequent and the prognosis remains poor despite early adequate antibiotic treatment.
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PMID:[Streptococcus (S. pyogenes) group A septicemia. Analysis of 20 cases in adults]. 633 81

Fundamental and clinical studies on cefotetan (CTT), a new cephamycin antibiotic, were carried out under a joint study programme in pediatric field, and the following results were obtained. Pharmacokinetic study In 20 pediatric patients with normal renal function, weighing 15 to 48 kg, CTT was injected intravenously at 20 mg/kg in 3 to 5 minutes. The mean blood concentration of CTT was 215.6 micrograms/ml at 15 minutes after the end of injection, 90.7 micrograms/ml at 1 hour, 57.2 micrograms/ml at 2 hours, 33.9 micrograms/ml at 4 hours and 10.2 micrograms/ml at 8 hours. The half-life of the drug in the beta-phase, computed from the mean blood concentrations up to 8 hours postdosing, was 2.61 hours. The peak of the mean urinary excretion of cefotetan appeared in 0 to 2 hours after the injection and 36.5% of the dose was recovered in the urine. The mean excretion at 0 to 8 hours was 68.1%. Clinical study Clinical effects of CTT was evaluated in 285 patients with 287 diseases, since 1 patient had both pneumonia and erysipelas, and another both pneumonia and acute otitis media. Daily dosage of CTT ranged from 15 to 123 mg/kg, and 266 patients (93.3%) received the drug either 2 or 3 times daily. The clinical response was seen in 83.3% of the 6 cases with sepsis, 89.3% of the 122 cases with pneumonia with or without pyothorax, 96.2% of the 52 cases with either acute bronchitis or tonsillitis, 92.5% of the 67 cases with urinary tract infection and 92.5% of the 40 cases with other infections. The causative organisms were detected in 160 patients and the rate of complete disappearance was 80.6%. Out of 310 patients, side effects were seen in 9 cases, diarrhea in 8 (2.6%) and rash in 1 (0.3%). Abnormal clinical laboratory findings were seen in 24 cases, elevation of serum transaminases in 19 (7.8%), elevation of TTT and LDH in 1 (0.4%) and eosinophilia in 4 (1.6%). None of these cases showed serious side effects or abnormal clinical laboratory findings. From the above results, it is concluded that CTT is one of the useful drug for treatment of infections in pediatric field.
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PMID:[Comprehensive evaluation of cefotetan in pediatrics]. 636 9

An 86-year-old woman developed large bullae on both legs during the course of septicemia due to Yersinia enterocolitica. Although erysipelas-like lesions and erythema nodosum have been known to be associated with Yersinia infections, this is the first reported case with multiple bullae.
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PMID:Bullous skin lesions associated with Yersinia enterocolitica septicemia. 637 69

The multiorgan failure syndrome caused by group A streptococci (GAS) designated streptococcal toxic shock syndrome (STSS) is believed to be mediated by cytokines induced by superantigens. In order to study the relationship between superantigen production, cytokine levels in patient sera, and clinical GAS manifestation we examined acute-phase sera and strains from 25 patients with GAS bacteremia. The patients had various disease manifestations, including STSS (44%), erysipelas (28%), septicemia (24%), wound infections (16%), and pneumonia (12%). Serotype T1M1 dominated, representing 56% of the isolates, but also strains of other serotypes were identified. The strains were found to produce the streptococcal pyrogenic exotoxins (Spe) A, B, and F, as determined by immuno-blot analyses. There was no difference in amounts of toxin produced between strains isolated from patients with different manifestations of disease. Levels of TNF alpha, IL1 alpha, IL6, IL8, and IFN gamma in acute-phase sera were determined by use of ELISA and RIA assays. The analyses showed higher levels of IL6 in sera from patients with STSS than in sera from patients with bacteremia without shock. TNF alpha was elevated in sera from patients with STSS, as compared to sera from patients with uncomplicated pharyngotonsillitis. No increase in the levels of IL1 alpha, IL8, and IFN gamma could be found in the patient sera and there was no difference in the level of those cytokines between the various patient categories.
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PMID:Correlation between serum TNF alpha and IL6 levels and severity of group A streptococcal infections. 766 74

A fourteen-year-old girl with acute otitis media died from gram positive sepsis and toxic shock despite intensive treatment. The definitive bacteriological results showed positive cultures for both S. aureus and S. pyogenes serotype A. In vitro the bacteria produced the bacterial superantigens TSST-1, enterotoxin A, enterotoxin C (S. aureus) and erythrogenic toxin C (S. pyogenes). The patient presented with large flaccid sterile bullae on her chest and arms as well as necrotizing fasciitis. Tzanck test showed keratinozytes without necrosis and no inflammatory cells. Frozen-section and conventional skin biopsy specimens revealed subcorneal intraepidermal cleavage. These cytological and histological findings are those of staphylococcal scalded skin syndrome (SSSS) and differ from bullous erysipelas or toxic epidermal necrolysis (TEN). Therefore bacterial exotoxins are most likely responsible for the intraepidermal blistering in our case just as in SSSS. Bullae are an unfavorable prognostic sign in gram positive toxic shock syndrome. Both Tzanck test and frozen-section biopsy are easy to perform and useful in the early and rapid recognition of gram positive bullous toxic shock syndrome.
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PMID:[Gram-positive septic-toxic shock with bullae. Intraepidermal splitting as an indication of toxin effect]. 903 30

One male of a group of seven Pacific white-sided dolphins (Lagenorhynchus obliquidens) died after a brief period of nonspecific clinical signs. Four beluga whales (Delphinapterus leucas) and four harbor seals (Phoca vitulina) were managed in the same water system. Gross examination of the dolphin revealed only moderately enlarged mesenteric lymph nodes. Histopathology revealed small to massive numbers of gram-positive bacilli, usually intravascular, in all tissues. Bacteria were both extracellular and present in macrophages, monocytes, and neutrophils. Aerobic bacterial culture of lung, liver, kidney, and spleen yielded pure cultures of Erysipelothrix rhusiopathiae. Based on clinical course, histopathology, and bacteriology, a diagnosis of acute erysipelas septicemia was made. None of the other cetaceans or pinnipeds exhibited clinical signs.
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PMID:Fatal Erysipelothrix rhusiopathiae septicemia in a captive Pacific white-sided dolphin (Lagenorhyncus obliquidens). 952 47

Erysipelothrix rhusiopathiae is a causal agent of swine erysipelas, which is of economic importance in the swine industry by virtue of causing acute septicemia, chronic arthritis, and endocarditis. However, little is known about the genetic properties of its protective antigens. Recently, a surface protective antigen (SpaA) gene was identified from serotype 2 in a mouse model. We cloned spaA from virulent strain Fujisawa (serotype 1a) and determined that the N-terminal 342 amino acids without C-terminal repeats of 20 amino acids have the ability to elicit protection in mice. Fusions of 342 amino acids of Fujisawa SpaA and histidine hexamer (HisSpa1.0) protected pigs against challenge with both serotype 1 and serotype 2, the most important serotypes in the swine industry. Pigs immunized with HisSpa1.0 reacted well with both HisSpa1.0 and intact SpaA by enzyme-linked immunosorbent assay and immunoblotting. Serum collected at the time of challenge from a pig immunized with HisSpa1. 0 markedly enhanced the in vitro phagocytic and killing activity of pig neutrophils against the bacteria. DNA sequences of protective regions of spaA genes from five strains of serotypes 1 and 2 were almost identical. The full DNA sequences also seemed to be conserved among strains of all 12 serotype reference strains harboring the spaA gene by restriction fragment length polymorphism analysis of PCR products. These results indicates that SpaA is a common protective antigen of serotypes 1 and 2 of E. rhusiopathiae in swine and will be a useful tool for development of new types of vaccines and diagnostic tools for effective control of the disease.
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PMID:Truncated surface protective antigen (SpaA) of Erysipelothrix rhusiopathiae serotype 1a elicits protection against challenge with serotypes 1a and 2b in pigs. 1045 77

In the clinical classification of leprosy the diffuse nonnodular form belongs to the lepromatous subtype. In these patients only a diffuse cutaneous infiltration without nodules or plaques is seen. Although the cutaneous features can be difficult to identify, the reactional state in these cases may lead to a serious necrotizing vasculitis, known as Lucio's phenomenon. We describe two cases of Lucio's phenomenon triggered by erysipelas. The diagnosis of leprosy was established only after the immunologic reaction had occurred. Both patients were treated with steroids and thalidomide. In the second case, the bacterial infection led to sepsis and death. In at-risk patients with a necrotizing vasculitis, leprosy should be considered in the differential diagnosis.
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PMID:[Postinfectious Lucio phenomenon in diffuse leprosy. Report of 2 cases]. 1118 45

Vibrio vulnificus is a halophilic gram-negative rod widespread in the aquatic environment and associated with primary septicemia and severe wound infections. The first Swedish case was reported in 1994. Ever since, sporadic cases have occurred in the south of Sweden whenever the coastal water temperature has exceeded 20 degrees C. Critical for a successful outcome in these infections has been early diagnosis with appropriate antibiotic and surgical treatment. A review of this subject was prompted by two cases of fulminant septicemia, which both presented themselves as atypical erysipelas.
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PMID:[Vibrio vulnificus. A marine bacterium with lethal potential]. 1152 58

A 7-month outbreak of 15 cases of postpartum sepsis with group A haemolytic Streptococci (GAS) was stopped when a carrier was identified. Comparing delivery dates with duty rotas revealed that the carrier had been present during delivery in 13 of the 15 cases. The epidemic GAS type, T3-13-B3264, was found in a carbuncle in her groin and in atopic dermatitis lesions behind her ears and on her eyelids. Thus, it was not the microbiological screening of staff that helped detect the carrier. The outbreak went unnoticed for 6 months, as no 2 cases were diagnosed by the same physician and 5 cases were diagnosed by different general practitioners. The main risk factors for infection were presence of the carrier relative risk (relative risk RR 47.8, 95% confidence interval (CI) 10.9-209.5) and suturing of episiotomy (RR 11.0; 95% CI 2.6-47.9). We recommend that a thorough epidemiological investigation should be carried out in every single case of GAS postpartum infection. Despite initial intravenous treatment with penicillin, 8 patients experienced > 15 recurring postpartum GAS infections, such as endometritis, wound infection, tonsillitis, erysipelas and Brodie's abscess. Eradication of GAS should be confirmed after completion of treatment.
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PMID:A 7-month outbreak of relapsing postpartum group A streptococcal infections linked to a nurse with atopic dermatitis. 1172 37


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