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

A case of an acutely beginning histologically proved panarteritis is described which was initiated by hepatitis B caused by blood transfusions. After one year of steroid therapy the arteritis was no longer seen histologically, Australia-antigen became negative. Terminally the patient developed an apoplexy, renewed gastric bleeding, septicemia with obstructive jaundice, nose bleeding, increasing renal insufficiency, and cardiac failure. The Australia-antigen reappeared in the serum. It could be assumed that the panarteritis had progressed. Immune complexes of Australia-antigen and corresponding antibodies which are deposited in the vascular wall and cause an inflammatory reaction, are being held responsible for the panateritis. They were proved serologically and by immunofluorescence in the vascular wall. In cases of panarteritis of unknown origin Australia-antigen can be found in a high percentage, as was demonstrated by a second case.
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PMID:[Hepatitis-B-surface antigen and panarteritis (author's transl)]. 4 44

Of 567 patients receiving renal transplantation at the University of Minnesota between October 1967 and October 1975, 22 developed clinical jaundice. Of these 22, nine died with their initial episode of hepatitis, six died within three months of causes associated with liver malfunction, four developed evidence of chronic hepatic failure and only three totally recovered from their illness. Five had clear evidence of Australia antigen positive hepatitis B, four of cytomegalovirus hepatitis, two of herpes hominis hepatitis, one of varicella zoster hepatitis and three of hepatic failure associated with systemic bacterial and/or fungal sepsis. Two of the 22 patients were thought likely to have cytomegalovirus hepatitis though definite proof was absent and in five patients a clear-cut etiology could not be made. In many of these patients the diagnosis was confounded by the previous presence of HB(s)Ag antigen and the frequent occurrence of a previous or concurrent infection with cytomegalovirus. The role of various drugs including azathioprine, sulfisoxazole, chlorpromazine, acetominophen, etc., could not be established but major roles for these agents in the face of the many viral and bacterial infections present in these patients is doubted. No clear-cut therapy could be established although it appears safe to discontinue azathioprine for longer or shorter periods of time with or without substitution of cyclophosphamide without serious deterioration of renal function. The problem of hepatic failure in transplant patients is still unsolved and will require a prospective study of etiologic agents and sub-clinical hepatic dysfunction in order to establish even the first principles of clinical-pathological correlation.
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PMID:Jaundice after renal allotransplantation. 21 23

The clinical course of a 26 year old female patient with acute liver necrosis and coma due to hepatitis B is reported. The disturbances of conciousness had improved. The patient survived 41 days after the beginning of the coma and developed liver cell regeneration and an acute post-hepatitic liver cirrhosis. As a grave complication a septicemia with aspergillus was observed. The patient died because of gastro-intestinal hemorrhage. At autopsy there were no signs of brain edema. The treatment consisted in: daily infusions with coenzyme A, nicotinamid-adenin-dinucleotide, alpha lipoic acid and cocarboxylase to improve the metabolic disorders and the clinical picture; mannitol intravenously to prevent and to treat cerebral edema; 33 charcoal-hemoperfusions to remove toxic substances of acute liver failure. Treatment of the aspergillus infection with 5-fluorocytosine and amphotericine B and infusion of concentrated ascites led to a decompensation of liver functions. From this observation the following conclusions can be drawn: after an acute viral hepatic necrosis, new synthetic functions and improvements of the disturbed intermediary metabolism in regenerated liver-cells can eventually be seen only after twenty-four to thirty days. With systematically applicated mannitol infusions it is possible to treat cerebral edema effectively.
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PMID:Treatment of fulminant hepatic failure with infusions of Co-factors and mannitol and charcoal-hemoperfusions during Forty-one days. 50 61

A case is described of an HIV+ man who was successfully treated for Hodgkin's lymphoma, but who later developed non-Hodgkin's lymphoma 3 years later when his immune system became suppressed. The patient was 22 years old when he presented with fever, asthenia, weight loss, and cervical lymphadenopathy. With Hodgkin's lymphoma he also had positive serology for HIV and hepatitis B. He was treated with alternate courses of MOPP and ABVD chemotherapy. In 1990 he again appeared with high fever, progressive cervical, axillary and inguinal lymphadenopathy, with hilar and mediastinal lymph node enlargement on x-ray. CD4 lymphocytes were 577/cubic mm, and the CD4/CD8 ratio was 0.57 (normal 1.8). His cervical lymph node biopsy was classified as non-B non-T large-cell anaplastic lymphoma which was EBV-positive. A Western Blot was positive for small amounts of p24 and p18 antigens. The man was treated with MACOP-B chemotherapy, with some results, but died of sepsis 6 weeks later. The relationships between Hodgkins and non-Hodgkin's lymphoma, the timing of the neoplasm in the course of HIV infection, and the possible re-activation of hepatitis virus were discussed.
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PMID:Non-Hodgkin's lymphoma after prolonged remission of Hodgkin's disease in an HIV-infected patient. 166 42

Infection of Pekin ducks with duck hepatitis B virus is a useful model for studying the hepadenoviruses, of which human hepatitis B virus is the prototype. The utility of this model has been limited, however, by the difficulties associated with anesthetizing and obtaining liver biopsies from ducks. We developed a technique using Telazol (13 mg/kg) to anesthetize ducks before surgical biopsy of the liver in ducks infected with duck hepatitis B virus. Eight Pekin ducks infected with duck hepatitis B virus underwent serial biopsies at 4- to 5-week intervals. There was one perioperative death in 34 surgical procedures with no evidence on intra-abdominal sepsis or wound complications. Telazol can be used safely and humanely to anesthetized ducks without the need for general endotracheal anesthesia.
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PMID:A technique for liver biopsy performed in Pekin ducks using anesthesia with Telazol. 166 51

Endogenous bacterial endophthalmitis occurred in a hepatitis B virus carrier during an episode of severe hepatitis complicated by anaerobic septicemia and possible spontaneous bacterial peritonitis. This may well represent another complication of severe hepatitis with anaerobic bacteremia.
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PMID:Endogenous septic endophthalmitis in severe acute hepatitis with septicemia. 176 44

To determine trends in a variety of dialysis-associated diseases and practices, the Centers for Disease Control surveyed 1,867 chronic hemodialysis centers in the United States in 1989 in conjunction with the annual facility survey performed by the Health Care Financing Administration. The response rate to a mailed questionnaire was 92%. These 1,726 centers represented 122,734 patients and 32,486 staff members. The following results were found. 1) During the last 14 years, the incidence of hepatitis B virus (HBV) infection decreased from 3.0 to 0.1% among patients, and from 2.6 to 0.1% among staff members. Over the same time, the prevalence of hepatitis B surface antigen (HBsAg) positivity declined from 7.8 to 1.4% among patients and from 0.9 to 0.3% among staff members. Hepatitis B vaccine was given by 92% of the centers. By the end of 1989, 19% of susceptible patients and 55% of susceptible staff members had received all three doses of hepatitis B vaccine. From 1982 to 1989, as a result of receiving vaccine, the prevalence of antibody to HBsAg (anti-HBs) increased from 12 to 19% among patients and from 18 to 54% among staff. The incidence of non-A, non-B hepatitis in 1989 was reported to be 0.7% among patients and 0.1% among staff members. 2) Twenty-two percent of the centers reported pyrogenic reactions in the absence of septicemia among their patients, and 51% reported septicemia. 3) The reported incidence of dialysis dementia among hemodialysis patients was 0.2%, with a case fatality rate of 23%. 4) In 1989, 68% of centers reported that they reused disposable dialyzers; these centers treated 73% of the dialysis patient population. Among centers that reused disposable dialyzers, the average number of reuses ranged from 1 to 50 (mean, 12) and the maximum number of times a disposable dialyzer was ever reused ranged from 3 to 150 (mean, 28). Chemical germicides used for reprocessing dialyzers included formaldehyde, Renalin (a peracetic acid-hydrogen peroxide-based germicide), and glutaraldehyde-based germicides. Reuse of disposable dialyzers was not associated with any increased risk of acquiring HBV infection among either patients or staff. However, pyrogenic reactions occurring in clusters were reported more frequently in centers that reused conventional dialyzer membranes compared with centers that did not. This increased risk was associated only with centers that used Renalin or glutaraldehyde for reprocessing (not formaldehyde) and occurred with both automated and manual reprocessing systems.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:National surveillance of dialysis-associated diseases in the United States, 1989. 183 Feb 8

An attempt was made to reduce the risk of infection following liver transplantation by means of selective bowel decontamination with tobramycin, polymyxin E and amphotericin B, as well as short-term systemic antibiotics with cephotaxim and tobramycin. After 53 consecutive orthotopic hepatic transplants performed in 51 patients between 1985 and 1987, a total of eight pneumonias occurred as the clinically most significant infection. Two pneumonias were caused by cytomegalovirus, one by Pneumocystis carinii, one by Candida and the remaining four by various bacteria. In 6 patients, bacteria were cultured from the blood, but only in one case was an indwelling catheter identified as the source of the septicemia. Taking all samples together, Streptococcus faecalis was the bacterium most frequently cultured, which was not covered by the prophylactic antimicrobial regime applied. Pseudomonas, however, and gram-negative bacteria were demonstrated much less frequently. Vaginal and oral Candida infections, as well as oral and genital herpes simplex infections, responded well to topical therapy with fungicide and aciclovir, respectively. Three patients developed cytomegalovirus (CMV) hepatitis. All five CMV infections were successfully treated with ganciclovir and hyperimmunoglobulin, as well as reduction of prophylactic immunosuppression. Out of 15 patients transplanted for posthepatitic cirrhosis, 7 developed a recurrence of the infection (5 hepatitis B virus) 2 hepatitis C virus) in the graft. Two died of the cirrhosis, three are still alive with cirrhosis but sufficient graft function, and one patient is suffering from chronic active hepatitis. One patient grafted for acute hepatic failure was able to clear the delta virus within 1 year post-transplant.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Personal experience with prevention and therapy of infection after 53 liver transplantations]. 187 Mar 61

This working party was convened by the organizers of the World Congresses of Gastroenterology, Sydney 1990. Its remit was to produce a report on disinfection in endoscopy. Endoscopy plays an essential role in the management of gastrointestinal disorders; its benefits far outweigh the occasional complications which arise. Nevertheless, case reports and surveys performed over a 20-year period confirm that endoscopic procedures do occasionally cause cross-infection and the current epidemic with human immunodeficiency virus (HIV) has highlighted the potential for more serious disease transmission if suitable precautionary measures are not generally applied in endoscopy practice. Contaminated equipment may cause infection in three ways: transmission of pathogenic organisms from one patient to another, the commonest example being Salmonellosis; transmission of infection such as hepatitis B (HBV) from patient to staff by needle-stick injury; and introduction of opportunistic organisms which colonize endoscopic and ancillary equipment on storage. This may cause focal sepsis or septicaemia, particularly in the immunocompromised, or cholangitis and pancreatic sepsis following endoscopic retrograde cholangiopancreatography (ERCP). These risks can be eliminated by the use of effective cleaning and disinfection techniques, by providing suitable staff training and by paying attention to endoscopy room procedures. Both HBV and HIV are inactivated by all currently accepted disinfecting or sterilizing procedures.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Disinfection and endoscopy: summary and recommendations. Working party report to the World Congresses of Gastroenterology, Sydney 1990. 188 72

Fifteen hepatitis B surface antigen (HBsAg) positive patients treated with orthotopic liver transplantation were studied to determine whether any clinical, serologic, or histologic data were predictive for recurrent hepatitis B infection leading to graft failure. Six patients died early, one due to primary graft nonfunction and the remaining five due to septic complications. There were nine patients surviving longer than two months, eight of whom are alive at a mean follow-up of 556 days. HBsAg and hepatitis B core antibody (anti-HBc) reappeared in the sera of all survivors after a variable transient period of clearance. One patient died 3 months posttransplant of fungal sepsis and was found to have histologic evidence for recurrent hepatitis and positive immunoperoxidase staining postmortem. The remaining eight survivors are home and clinically well, with no histologic evidence of hepatitis. Seven of these eight patients have hepatitis B viral DNA in their sera. We conclude that while there is a high early mortality, usually from sepsis, none of the serologic, histologic, or DNA data analyzed can be used to predict graft loss from recurrent hepatitis. No grafts have been lost due to recurrent hepatitis B in this series, and therefore we believe that HBsAg positive patients should not be excluded from transplantation.
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PMID:Serologic and DNA follow-up data from HBsAg-positive patients treated with orthotopic liver transplantation. 190 76


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