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

Infections due to Aeromonas hydrophila and Plesiomonas shigelloides in immuno-compromised hosts have been well documented, but the role of these organisms in causing gastrointestinal disease in healthy persons is controversial. Despite difficulties in characterizing the exotoxins produced by Aeromonas species, there is accumulating evidence that these bacteria are capable of causing usually mild, self-limited diarrheal disease in previously healthy adults. Some pediatric patients may have protracted dysenteric symptoms. P. shigelloides, an organism closely related to Aeromonas species, may also cause diarrhea in the healthy host, but no exotoxins have yet been identified by the assays used to identify other bacterial enterotoxins. Replacement of fluid and electrolytes is the basis of treatment, and antimicrobial agents should be reserved for patients with chronic or serious illness, or for those at particular risk of serious illness (hepatobiliary disease, septicemia, neoplasms).
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PMID:Aeromonas hydrophila and Plesiomonas shigelloides as causes of intestinal infections. 639 Jun 38

Vibrio vulnificus causes soft-tissue infections, gastrointestinal disease, and severe sepsis in humans. Bacterial and host factors in virulence have remained poorly defined. We found that blood culture isolates of V. vulnificus were completely resistant to the bactericidal effects of 10% normal human serum, in contrast to soft-tissue and environmental isolates that showed a mean 2.6 log10 decline during 120 min of incubation. Following opsonization by 10% normal human serum, mean uptake of blood isolates by normal human polymorphonuclear leukocytes during 20 min of incubation in vitro was 45.8% compared with 83.2% for isolates from other sites. Blood isolates were lethal for suckling mice (mean LD50, 1.3 X 10(6)) in contrast with isolates from other sites, which were less virulent (mean LD50, 1 X 10(9)); lethality correlated well with bacteremia at 6 hr. These studies show a close correlation between bacterial virulence for humans and suckling mice and suggest that resistance to the bactericidal and opsonizing effects of normal human serum may be important factors governing that virulence.
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PMID:Resistance of Vibrio vulnificus to serum bactericidal and opsonizing factors: relation to virulence in suckling mice and humans. 648 Nov 86

A 66-year-old man had pneumonia, lung abscesses, and mediastinal adenopathy develop due to Yersinia enterocolitica. There was no evidence of septicemia or acute gastrointestinal disease. Diagnosis was confirmed by cultures of a transtracheal aspirate and sputum. Treatment with cefamandole nafate, which had not been used previously in Y enterocolitica lung disease, resulted in cure.
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PMID:Yersinia enterocolitica lung infection. 728 67

A 10-year retrospective analysis has been carried out of 114 patients dialysed for acute renal failure. Fifty-eight patients, predominantly suffering from multiple organ failure, required treatment in an Intensive Therapy Unit (ITU); 56 less severely ill patients were treated in a Renal Unit. Overall survival in the former group was 36% and in the latter group 63%. In the first 5 years of the study, survival in the ITU patients was 31% and in the second 5 years, was 38% in spite of a trend towards increased severity of illness. These results challenge the view that haemodialysis is rarely worth-while in patients with multiple organ failure, and suggest that current management techniques have improved prognosis. The most important adverse factors continue to be old age, sepsis and gastrointestinal disease.
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PMID:Survial from acute renal failure with and without multiple organ dysfunction. 743 23

The aims of this retrospective study were to review the frequency and patterns of bacterial sepsis in children infected with human immunodeficiency virus. The charts of 233 human immunodeficiency virus-infected children cared for during a 10-year period in 4 tertiary hospitals in Madrid were reviewed. There were 43 episodes of sepsis in 31 (13%) children. Twenty of them had acquired immunodeficiency syndrome, 10 were class PA2 and 1 was class P1B. The most common organisms recovered were: nontyphoidal Salmonella, 10 cases (23%); Streptococcus pneumoniae, 9 cases (21%); Staphylococcus epidermidis, 6 cases (14%); Escherichia coli, 5 cases (12%); Enterococcus faecalis, 4 cases (9%); Campylobacter jejuni, 2 cases (5%). In 28 episodes of bacteremia there were other sites of associated infection: pneumonia, 6 cases; urinary tract infection (UTI), 5 cases; gastrointestinal disease, 4 cases; catheter-related bacteremia, 12 cases. Eight patients had more than 1 episode of bacteremia. The rate of complications was high: 6 children had septic shock; and 2 of them developed disseminated intravascular coagulation. There was 1 death directly related to sepsis.
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PMID:Sepsis in children with human immunodeficiency virus infection. The Madrid HIV Pediatric Infection Collaborative Study Group. 766 58

A comprehensive study of the course of the early neonatal period in 120 newborns infected with Chlamydia, analysis of somatic and obstetrical and gynecological anamnesis and the course of gestation, labor, and postpartum period in their mothers, and prospective clinical and microbiological examinations of these infants up to the age of 1 year revealed that the fetus is infected not only during delivery, but antenatally as well. The disease runs an extremely grave course in the neonates, often with generalization of the process. Chlamydial infection in the early neonatal period depends on the time and massiveness of infection of a child, the degree of morphofunctional maturity of the baby and presence of concomitant diseases related to unfavorable conditions of intrauterine development; it may take the following clinical forms: intrauterine sepsis, meningoencephalitis, intrauterine pneumonia, respiratory distress syndrome, gastroenteropathy, conjunctivitis. Problems in the diagnosis and treatment of the disease are discussed.
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PMID:[Current problems in the clinical course, diagnosis and treatment of Chlamydia infection in newborns]. 776 42

Yersinia enterocolitica has been described with increasing frequency in the United States. Commonly, Y enterocolitica is a self-limiting gastrointestinal disorder, but occasionally it can lead to fulminant infection. This case report describes a 3-week-old male who succumbed to Y enterocolitica sepsis and reviews the literature.
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PMID:Yersinia enterocolitica sepsis in a 3-week-old child. 780 64

Vibrio hollisae, one of the more recently described halophilic Vibrio species, is infrequently associated with gastrointestinal disease and only rarely recovered from individuals presenting with gram-negative sepsis. In this report we describe two cases of severe gastrointestinal disease associated with V. hollisae in otherwise healthy individuals. In one of these individuals, severe epigastric pain was apparently associated with signs of pseudoappendicitis, necessitating exploratory surgery. In both individuals, infection was associated with the ingestion of raw shellfish. These cases are discussed in light of previous reports on the epidemiology, pathogenesis, and spectrum of disease caused by this unusual pathogen.
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PMID:Severe gastroenteritis associated with Vibrio hollisae infection: report of two cases and review. 801 9

Heparin is used clinically in horses to treat hemostatic abnormalities associated with severe gastrointestinal disease, septicemia, and endotoxemia. The primary anticoagulant effect of heparin is through the suppression of thrombin-dependent amplification of the coagulation cascade, and inhibition of thrombin-mediated conversion of fibrinogen to fibrin. Heparin may be of benefit in preventing the complications associated with hypercoagulable states such as jugular vein thrombosis, laminitis, and organ failure. Heparin may also be beneficial in the prevention of intraabdominal adhesions after gastrointestinal surgery, and in amelioration of hemodynamic abnormalities associated with endotoxic shock. Because a sequential rise in serum heparin concentration occurs during a uniform dosage regimen, a decreasing dosage regimen is recommended. The initial dose recommended is 150 U heparin/kg body weight subcutaneously, followed by 125 U heparin/kg body weight subcutaneously, every 12 hours for six doses. The dose should be decreased to 100 U heparin/kg body weight subcutaneously, every 12 hours, after the seventh dose. Anemia, hemorrhage, thrombocytopenia, and painful swelling at injection sites are complications of heparin administration in horses.
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PMID:Heparin: a review of its pharmacology and therapeutic use in horses. 817 60

Cholestatic jaundice is the major complication of total parenteral nutrition (TPN) in infants and children. The pathogenesis of this syndrome is poorly understood. The aims of this study were: (1) to define the histologic liver injury in relation to the clinical course of infants on TPN and (2) to determine whether enteral feeding will reverse or halt these changes. We identified 31 infants treated for severe gastrointestinal disease for whom liver histology was available from 1987 to 1991. Clinical records and liver biopsy (23) or autopsy specimens (13) were reviewed. Five patients had biopsies at two subsequent operations. The clinical diagnosis was necrotizing enterocolitis (24), atresia or stenosis (3), midgut volvulus (2), Hirschsprung's disease (1), and sepsis (1). Twenty-one of 31 infants were premature and had a mean birth weight of 1,868 g. Twenty-five of 31 were on TPN and 28 of 31 had received some enteral feeding by the time of the biopsy. Enteral feeding was begun as early as possible in all infants even if continued TPN was necessary for full support. Cholestasis occurred in 71% of premature infants versus 22% of full-term babies. Infants with cholestasis had been on TPN for a longer time (37 days v 18) with a correspondingly shorter period of enteral feeding (17 days v 27). Mean total bilirubin level was 14 in patients with cholestasis and 5 in those without, but the bilirubin level did not correlate with the extent of histological injury and was frequently normal despite marked histological damage.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Total parenteral nutrition-associated cholestasis: clinical and histopathologic correlation. 826 85


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