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

During March-August 1990 in Zimbabwe, researchers reviewed the medical records of 500 consecutive patients, 0-12 years old, at Harare Hospital and Parirenyatwa Hospital to lean what the most frequent pediatric diagnoses were and to compare prescribing patterns. These hospitals were of comparable size but served different populations. Patients at Harare Hospital tended to have a lower income and be children than those at Parirenyatwa Hospital. Parirenyatwa Hospital specialized in cardiovascular, hematology, medicine, and oncology services. Clinicians identified 737 diagnoses. The most common diagnoses included respiratory infections (39.4% of patients), gastroenteritis (16.8%), malnutrition (10.4%), sepsis (9.6%), and AIDS (8.6%). 97.8% of the children received at least 1 medication (1725 prescriptions). The mean drugs prescribed per patient stood at 3.45 (range, 0-18). Patients with AIDS accounted for the high end of the range. The most frequently prescribed drug type was antibiotics (about 35%), especially penicillin. The recommended duration of antibiotic treatment is 7-14 days, but the mean duration among these children was only 5.1 days. Harare Hospital had more patients admitted for infections and neurologic conditions than did Parirenyatwa Hospital (47.1% vs. 35.% and 4.5% vs. 2%, respectively), which accounted for the higher prescription rate for anti-infective drugs and central nervous system drugs at Harare Hospital (55.4% vs. 47.3%, and 3.5% vs. 2.6%, respectively). Parirenyatwa Hospital had more surgical procedures and febrile convulsions than Harare Hospital, which explained why it had higher prescription rate for analgesics (12.5% vs. 8.7%). It also had more children diagnoses with respiratory infections. Harare Hospital had more malnutrition, sepsis, and AIDS pediatric cases. Since the two hospitals served different socioeconomic populations, it was not surprising to find differences in prescription patterns, which were appropriate and tended to abide by the Essential Drugs List recommendations.
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PMID:Diagnoses and prescribing for pediatric patients at two hospitals in Harare, Zimbabwe. 836 78

In 1989, the first year of coordinated Vibrio surveillance in four Gulf Coast states (Alabama, Florida, Louisiana, and Texas), 121 infections were reported. These included 34 V. parahaemolyticus, 30 V. cholerae non-O1, 18 V. vulnificus, 9 V. hollisae, 7 V. alginolyticus, and 7 V. fluvialis. Fourteen patients had primary septicemia, 71 had gastroenteritis, and 29 had wound infections; 7 had other or unknown illnesses. Sixty-six patients were hospitalized, and 9 died. All patients with primary septicemia, but only 17% of those with gastroenteritis, were known to have an underlying illness (P < .001). Among patients for whom data were available, 67% with primary septicemia and 74% with gastroenteritis ate raw oysters in the week before illness began. Of 50 patients with data on where oysters were obtained, 42 (84%) ate them at oyster bars or restaurants. These data provide evidence that in the Gulf Coast region raw oyster consumption is an important cause of Vibrio-associated gastroenteritis among adults without underlying illnesses.
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PMID:Vibrio infections on the Gulf Coast: results of first year of regional surveillance. Gulf Coast Vibrio Working Group. 842 Nov 86

Post-transfusion bacterial sepsis is infrequent. It is, however, associated with a high mortality due to septic shock. This reflects the release of endotoxin from gram negative bacteria. Lesser transfusion reactions are usually under-reported. These are frequently caused by gram positive bacteria. Gram positive species such as staphylococci and other skin surface organisms may be cultured from platelets stored at room temperature. Typically, gram negative "psychrophyllic" species which survive storage at 4 degrees C are cultured from stored refrigerated blood implicated in transfusion reactions. These include Yersinia enterocolitica, Pseudomonas fluorescens etc. Bacterial contamination of the blood supply can occur via an endogenous or an exogenous source. Endogenous donor bacteraemia due to Y.enterocolitica may be asymptomatic or may follow an episode of gastroenteritis. Exogenous infections occur through some defect in the usual collection practice. Transfusion-acquired syphilis is now extremely uncommon. In the third world, beside the need for effective screening for viral pathogens, infections with protozoa, in particular plasmodia, trypanosoma and leishmania remain a major obstacle to ensuring safe blood supplies. Prevention of transfusion reactions demands rigorous attention to details of collection, storage, reissuing and infusion of blood products, as well as prompt treatment, testing and reporting of suspected reactions.
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PMID:Hazards of bacterial contamination of blood products. 844 1

A 12-year review identified 21 patients with nontyphoidal, nonparatyphoidal salmonella septicemia. Eight of the patients had no predisposing factors. Factors identified included malignancy in five, recent surgery in four, alcoholism with aspiration pneumonia in two, chronic lung disease in two, diabetes in two, systemic lupus erythematosus in one and burns in one. Ten patients presented with gastroenteritis, two with localized abscesses, two with aspiration pneumonia and the remainder with nonspecific septicemia. Three patients died of underlying diseases and three died shortly after the septicemia of related causes. Six cases were nosocomial infection and were not related to hospital outbreaks. Salmonella septicemia with these serotypes is uncommon (1 per 14,000 admissions, 1 per 4000 blood cultures) and can occur in patients without diminished host resistance.
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PMID:Nontyphoidal, nonparatyphoidal salmonella septicemia in adults. 850 19

There is considerable mortality in sub-Saharan Africa relative to other regions in the world. No country in Africa, however, has a system of vital registration capable of providing reliable national data on mortality. Accurate information on the causes of adult mortality is therefore very limited. This lack of knowledge is becoming especially important in light of the impact HIV infection and AIDS are having in many sub-Saharan African countries. The authors documented the pattern of adult medical deaths in Queen Elizabeth Central Hospital, Blantyre, Malawi between April 1992 and March 1993. Their findings were then compared with data on mortality collected from the same wards in 1973, before the AIDS pandemic. Tuberculosis (TB) and AIDS together accounted for 49% of all medical deaths in 1992-93, with 82% of deaths occurring among individuals aged 13-49 years. TB, AIDS, gastroenteritis, pneumonia, pyogenic meningitis, and septicemia were the most important causes of death. In 1973, TB was responsible for 13% of deaths and there were no deaths due to AIDS. The authors note that the predicted upsurge in the level of AIDS-related mortality in sub-Saharan Africa during the 1990s will have grave consequences for the health sector, as well as for the social and economic fabric of the countries concerned.
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PMID:The changing pattern of mortality in an African medical ward. 856 May 90

The epidemiology of 690 Vibrio infections reported in Florida during 1981-1993 is described. Most infections resulted in one of three clinical syndromes: gastroenteritis (51%), wound infections (24%), or primary septicemia (17%). Case-fatality rates were 1% for gastroenteritis, 5% for wound infections, and 44% for primary septicemia. While gastroenteritis had little seasonal variation, 91% of primary septicemias and 86% of wound infections occurred from April through October, mostly due to the seasonality of Vibrio vulnificus and Vibrio parahaemolyticus infections. Infected wounds were largely a result of occupational activities around seawater. Some 68% of gastroenteritis cases and 83% of the primary septicemias were associated with raw oyster consumption. Preexisting liver disease was present in 48% of patients with primary septicemia and was associated with a fatal outcome in both wound infections (relative risk [RR], 28.3; 95% confidence interval [CI], 6.3-127.5; P < .0001) and primary septicemia (RR, 1.9; 95% CI, 1.2-3.1; P < .01).
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PMID:The epidemiology of Vibrio infections in Florida, 1981-1993. 862 70

Aeromonas spp. are Gram-negative rods of the family Vibrionaceae. They are normal water inhabitants and are part of the regular flora of poiquilotherm and homeotherm animals. They can be isolated from many foodstuffs (green vegetables, raw milk, ice cream, meat and seafood). Mesophilic Aeromonas spp. have been classified following the AeroKey II system (Altwegg et al., 1990; Carnahan et al., 1991). The major human diseases caused by Aeromonas spp. can be classified in two major groups: septicemia (mainly by strains of A. veronii subsp. sobria and A. hydrophila), and gastroenteritis (any mesophilic Aeromonas spp. but principally A. hydrophila and A. veronii). Most epidemiological studies have shown Aeromonas spp. in stools to be more often associated with diarrhea than with the carrier state; an association with the consumption of untreated water was also conspicuous. Acute self-limited diarrhea is more frequent in young children, in older patients chronic enterocolitis may also be observed. Fever, vomiting, and fecal leukocytes or erythrocytes (colitis) may be present (Janda, 1991). The main putative virulence factors are: exotoxins, endotoxin (LPS), presence of S-layers, fimbriae or adhesins and the capacity to form capsules.
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PMID:Emerging pathogens: Aeromonas spp. 875 Jun 64

Hafnia alvei is a gram-negative bacterium that is rarely isolated from human specimens and is rarely considered to be pathogenic. It has been associated with gastroenteritis, meningitis, bacteremia, pneumonia, nosocomial wound infections, endophthalmitis, and a buttock abscess. We studied 80 H. alvei isolates recovered from 61 patients within a period of 30 months. H. alvei was cultured from sites that included the respiratory tract (n = 38), the gastrointestinal tract (n = 16), and the urogenital tract (n = 12); the organism was found in blood cultures (n = 8), on central venous catheters (n = 3), and on the skin (n = 3). Only 25% of H. alvei isolates were recovered in pure cultures. Fifty-seven (93.4%) of the patients had an underlying illness. H. alvei proved to be the etiologic agent in two episodes of septicemia and in one episode of peritonitis and was probably responsible for septicemia in two other patients and pneumonia in one. All six of these patients recovered after receiving antibiotic treatment and/or standard surgical treatment, when needed. Three of these infections were nosocomial, and three were community acquired. Of the strains of H. alvei tested in our study, 100% were susceptible to netilmicin, ciprofloxacin, and imipenem; 92% were susceptible to piperacillin; 90% were susceptible to co-trimoxazole; and 88% were susceptible to ceftriaxone and ceftazidime. In this study, we found H. alvei to be a rare significant etiologic agent of nosocomial and community-acquired infections.
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PMID:Clinical significance of extraintestinal Hafnia alvei isolates from 61 patients and review of the literature. 878 7

A male infant was born with generalized erythroderma and scaling; the newborn demonstrated poor neonatal development and developed several complications such as hypernatremic dehydration, septicemia, gastroenteritis and seizures. In the neonatal period, the erythema faded, but exfoliation persisted. The parents are healthy but related. One older brother, who died at the age of 3 months, had shown the same clinical picture in the neonatal period and was diagnosed with congenital psoriasis. All clinical investigations, including serum immunoglobulins, complement levels and lymphocyte counts, were normal. Only raised total IgE and multiple positive specific IgE reactions were noted. Skin biopsy revealed an image of ichthyosis. Polarization microscopy of scalp hair showed trichorrhexis nodosa and discrete focal twisting of the hair shaft. This clinical picture and all histological findings are compatible with the indications of Netherton's syndrome. The purpose of this report is to call attention to this severe presentation of congenital ichthyosis in the neonatal period and to the difficulty of a correct diagnosis when confronted with congenital erythroderma.
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PMID:Netherton's syndrome: a severe neonatal disease. A case report. 886 92

Vibrio vulnificus has been associated with three main clinical syndromes; primary septicemia; wound infection, and gastroenteritis. This organism has increased virulence for persons with underlying medical conditions that predispose to iron overload or an impaired immune system. Since the organism proliferates more readily in warm, coastal waters, such infections are more commonly found in those regions. Infection can result from the ingestion of contaminated, undercooked seafood; contact of a wound with seawater; or a puncture wound sustained from a contaminated surface. Vibrio infections rarely occur in inland areas, but when they do occur, they are usually a result of the contact of wounds with contaminated, brackish water or the ingestion of raw shellfish. Because infections with this organism occur less frequently in non-coastal regions, the diagnosis may not be suspected initially in susceptible individuals and a delay of treatment may result. We present a case of V. vulnificus sepsis occurring in a man with underlying liver disease and a history of row oyster consumption in Oklahoma and discuss the clinical manifestations of primary sepsis with this organism as well as prevention strategies.
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PMID:Overwhelming sepsis with Vibrio vulnificus: a coastal pathogen in Oklahoma. 893 53


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