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

Infections in patients with gynecologic malignancies occur frequently and are the cause of death in 50 to 60% of the cases. The patient with cancer is a compromised host with an increased susceptibility to infection due to the malignancy itself on the one hand and due to therapeutic-modalities, like extensive surgical procedures, radiation- and cytotoxic chemotherapy on the other hand. Aetiologically these infections are mostly due to a disruption of anatomic structures which normally prevent the invasion of exogenous or endogenous microorganisms, or to obstructive processes or to tumour necrosis. Septicaemia can result from propagation of such a localized infection beyond the site of the tumour. The causative pathogens infecting the compromised host are mostly members of the indigenous microbial flora of the genital tract, which is influenced by surgery, irradiation and chemotherapy. Postoperatively in the vaginal vault the number of most potentially pathogenic aerobic and anaerobic bacterial species is higher, polymicrobial mixed infections are frequent. Neither the intracavitary radiation-therapy with Radium or Iridium-192 (afterloading) nor the external high-voltage therapy decrease the number of pathogenic bacterial species in the uterus and in the vagina of patients with cervical or endometrial cancer. The symptoms of infection in cancer patients can be "masked". Fever in patients with genital malignancies is mostly due to local infections and influences the prognosis negatively. The 5-year survival rate of irradiated patients with fever is significantly lower. Infections following radical hysterectomy, irradiation and/or cytotoxic chemotherapy like pelvic abscesses, peritonitis, pneumonia and septicaemia can be fatal. Urinary-tract-, wound- and vaginal vault-infections occur frequently, but are rarely severe. Therapeutically in severe infections a combination antibiotic therapy, which is effective against most pathogenic members of the genital flora, is required. Short courses of perioperative prophylactic antibiotics are useful both in radical hysterectomy and with intracavitary irradiation.
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PMID:[Infections in patients with gynecologic malignancies]. 641 69

Animal models were established for Staphylococcus aureus generalized infection (septicemia), and for localized S. aureus infection (osteomyelitis and empyema) to evaluate the possible use of a S. aureus latex agglutination (Lat-SA) test as an indicator of S. aureus infection. Plasma, obtained from animals before and after S. aureus challenge, was used for the test. In the models of generalized infection, all nine rabbits and 13 of 20 (65%) rats had a positive Lat-SA test together with a positive blood culture. Only 3 of the 14 (21%) rats with negative blood cultures after S. aureus challenge had a positive test (P less than 0.05). In the models of localized infection, plasma samples were positive in all animals at some time after bacterial challenge, even if the animal was not bacteremic. Aspirates from bone marrow (2/2) for the osteomyelitis model and pleural exudate (2/2) for the empyema model were Lat-SA test positive and yielded S. aureus on culture. Plasma obtained from these animals before injection with bacteria were all negative by the Lat-SA test, as were plasma samples obtained from two rabbits after injection with S. epidermidis. Since these models mimic human disease, the Lat-SA test may be useful as a diagnostic aid for S. aureus infection in man. Further studies will be necessary to evaluate this.
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PMID:Staphylococcus aureus latex agglutination (Lat-SA) test for the diagnosis of S. aureus infection. 667 59

This paper traces the history of the theory of focal infection--which related a number of general conditions to septic foci from which toxic products spread to different parts of the body--and its application to dental diseases in early 20th century Britain. Bad teeth were said to be one of the major sources of infection and a cause of many diseases. The paper focuses on the social and professional context in which the theory emerged and flourished. It shows that in spite of its lack of scientific foundation, the theory of focal sepsis was readily accepted by the dental profession and used to advance its claims for professional recognition. Thus the paper attempts to illustrate the point that the acceptance of a medical theory by health practitioners is as much determined by social and economic factors as by its therapeutic potential or its scientific validity.
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PMID:Medical theories and professional development. The theory of focal sepsis and dentistry in early twentieth century Britain. 675 68

Vibrio vulnificus is a potentially lethal marine bacterium that has not been previously described in podiatric literature. A review of the microorganism's characteristics, susceptible patient population, and lower extremity manifestations of infection is presented. V. vulnificus is found as part of the normal flora of the Gulf of Mexico, Atlantic, and Pacific coastal waters and is often isolated from the filter feeding shellfish of these regions. Its pathogenicity is generally reserved for the immunocompromised host, and is specifically related to disease states which exhibit high serum iron levels. V. vulnificus infections present in two distinct clinical syndromes: primary sepsis secondary to raw oyster ingestion, or localized infection from wound exposure to V. vulnificus-inhabited salt water. Both syndromes demonstrate characteristic skin lesions of the trunk and extremities that present as hemorrhagic bullae and progress to necrotic ulcerations. Although V. vulnificus infection is rare, its extreme virulence in patients suffering from a chronic disease process and its manifestation of characteristic lower-extremity lesions require the podiatric physician to be able to recognize and treat such a condition.
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PMID:Lower extremity manifestations of Vibrio vulnificus infection. 748 92

We determined prospectively during a 12-month period the incidence, clinical characteristics and outcome of Yersinia enterocolitica infection in 144 thalassemic patients (mean age, 12.8 years) and compared them with 100 controls (mean age, 12.1 years). Symptomatic Y. enterocolitica infection occurred in 14 (10%) of the thalassemic patients and in 2 (2%) controls (P = 0.017). Of the 14 thalassemic patients 5 (36%) had septicemia and 9 (64%) had focal infection (enteritis in 8 and tonsillitis in 1). One control patient had acute enteritis and the other had tonsillitis. All isolates from these patients belonged to pathogenic phenotypes of Y. enterocolitica. Pending culture results symptomatic thalassemic patients discontinued treatment with deferoxamine and were treated with intravenous antibiotic therapy. Patients with the ultimate diagnosis of focal Y. enterocolitica infection continued treatment with intramuscular ceftriaxone or intravenous trimethoprim/sulfamethoxazole (TMP/SMX) for 7 days, whereas those with septicemia continued treatment with intravenous TMP/SMX for 14 days. The outcome was favorable in all 14 thalassemic patients. We conclude that Y. enterocolitica is a significant cause of morbidity in our patients with thalassemia and that prompt antibiotic therapy might prevent life-threatening conditions as well as a complicated course with long term sequelae.
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PMID:Prospective study of Yersinia enterocolitica infection in thalassemic patients. 756 85

Seven patients with infected transvenous dual chambered pacemakers have undergone removal of the device using cardiopulmonary bypass. There were four women and three men with a mean age of 58 years. Six patients had localized infection in the generator pocket (mean of 4.6 previous unsuccessful operations for surgical sterilization). Four infections were due to Staphylococcus epidermidis, two to Staphylococcus aureus, and one patient presented septicemia caused by Staphylococcus epidermidis and Pseudomonas aeruginosa. The atrial and ventricular transvenous electrodes were removed under direct vision using cardiopulmonary bypass. A new dual chambered epicardial pacemaker was implanted. The procedure was well-tolerated, and all patients are infection free with working pacemakers after a mean follow-up of 25.4 months.
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PMID:Removal of infected dual chambered transvenous pacemaker and implantation of a new epicardial dual chambered device with cardiopulmonary bypass: experience with seven cases. 765 81

Fifty-five children with culture-proved melioidosis treated at Srinagarind Hospital from 1979 to 1993 were retrospectively reviewed. Twenty patients had septicemia and 35 patients had localized infection. Eleven patients (55%) in the septicemic group had underlying diseases but none in the localized infection group. In the septicemic patients the most common organ involvement was the lung (75%). Shock was present in 45% and the case fatality rate was very high (60%). In localized melioidosis suppurative parotitis was the most common manifestation (40%). Other common infections included skin and subcutaneous abscesses and lymphadenitis. There was no shock or death in this group.
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PMID:Clinical manifestations of melioidosis in children. 774 96

The experience with the use of endolymphatic therapy (ET) in 110 patients with purulent surgical infection (50--with acute sepsis, 60--with localized infection against the background of diabetes mellitus) has been summarized. In acute sepsis, ET was the basis for the other methods of detoxication, the effect of its isolated use was a short-term one. In local purulent inflammation against the background of diabetes mellitus, the use of ET is highly effective, it can be used in the preoperative preparation of the patients with necrotic lesion of the lower extremities for improvement of the results of operative treatment.
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PMID:[The use of endolymphatic therapy in patients with a suppurative surgical infection]. 780 4

Interferon-gamma (IFN-gamma) has been demonstrated to improve outcome following localized infection and hemorrhagic shock in experimental studies. We sought to determine the effects of IFN-gamma in a clinically relevant murine model of intra-abdominal polymicrobial sepsis. Fifty male BDF1 mice, each weighing 23-28 g, underwent cecal ligation and puncture (CLP) followed by administration of subcutaneous injections of IFN-gamma 100-22,500 U or vehicle control immediately post-CLP and then daily. In a second set of experiments, 60 mice underwent daily injections of vehicle control or 100 U IFN-gamma 24, 48, or 72 hours prior to CLP. Interferon-gamma administered following CLP led to increased mortality and earlier deaths in a dose-dependent fashion (p < 0.05). Interferon-gamma given 24, 48, or 72 hours prior to CLP resulted in no demonstrable benefit when compared with animals that did not receive IFN-gamma (p = 0.14, p = 0.94, and p = 0.97, respectively). While IFN-gamma has been reported to be of value in selected clinical situations by improving resistance to infection, it may not be capable of conferring protection following surgery or trauma with intra-abdominal sepsis, and in fact may be detrimental.
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PMID:Interferon-gamma increases mortality following cecal ligation and puncture. 818 58

Massive hemolysis and renal failure are rare complications of infection with Clostridium perfringens, resulting in a very high mortality rate (70-100%). The severity of the infection depends on the presence of underlying conditions such as malignancies and diabetes mellitus. In patients without underlying disorders, massive hemolysis and anuria have been observed in only eight cases, according to recent reports. This case report describes a 61-year-old man who died of C. perfringens septicemia with massive hemolysis and anuria less than 4 h after admittance to the hospital, despite rapid and adequate antibiotic treatment. No focal infection was found.
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PMID:Clostridium perfringens septicemia with massive hemolysis. 844 84


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