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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 biochemically typical Yersinia enterocolitica usually present as gastroenteritis, mesenteric lymphadenitis, terminal ileitis, and septicemia often with visceral abscesses. In these instances, the isolates have been biochemically typical and of well-established serotypes, namely 0:3 or 0:9 and, in the United States, 0:5 or 0:8. The recovery, recognition, and significance of biochemically and serologically atypical Y. enterocolitica in human infections has proceeded more slowly. From an analysis of the clinical histories of 20 patients infected with 21 such aberrant Y. enterocolitica, it appears that these strains are of restricted pathogenic potential, producing various clinical entities such as localized skin abscesses, conjunctivitis, self-limiting enteritis, and wound and urinary tract infections in hosts with predisposing factors. Epidemiologically, whereas episodic acquisition of atypical strains by hospitalized patients is indicative of nosocomial transmission, in the present series sporadic isolations over a 4-year period, mainly from ambulatory patients, suggest an occult reservoir in the community serviced by The Mount Sinai Hospital. In contrast to typical Y. enterocolitica, which has become well adapted in animal and human hosts, it appears that environmental strains may be in the evolutionary process of becoming adapted to humans.
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PMID:Atypical Yersinia enterocolitica: clinical and epidemiological parameters. 67 Mar 80

The experience gained with restorative proctocolectomy and ileal reservoir in 60 patients is presented. Fifty-two patients had W reservoirs and the operative technique of the procedure is described in detail. Forty patients had a defunctioning ileostomy and 20 had a single stage procedure. There was no perioperative mortality. The main complications were sepsis (28 per cent), intestinal obstruction (18 per cent) and reservoir ileitis (20 per cent). There was a significant improvement in sepsis rate (from 20 to 4 per cent) and hospital stay (from 31.8 to 15.6 days) with increased experience. The functional results of 48 patients with W reservoirs was assessed. The mean number of evacuations per 24 h (+/- s.d.) was 3.8 +/- 0.2. Sixty-five per cent of patients did not evacuate at all, or rarely, at night and none evacuated more than once at night. Forty-four per cent of patients took antidiarrhoeal agents. Continence was normal in 50 per cent of patients. Minor leakage occurred in 46 per cent of cases, frequent leakage in 4 per cent and incontinence in none. Sexual function in 29 men was normal. Ninety-four per cent of patients considered the results of their operation to be good or excellent.
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PMID:Experience of restorative proctocolectomy with ileal reservoir. 253 30

Of 72 patients who underwent jejunoileal bypass because of morbid obesity, 69 could be evaluated with special reference to long-term (median 11 years) results. One of the other three had fatal anastomotic leakage, one underwent resection and reversal of shunt because of postoperative gangrene in the bypassed segment, and one died of sepsis and liver failure following cholecystectomy 6 months after bypass. The median body mass index (kg/m2) fell from 45.4 preoperatively to 33.2 after 16 years. Shunt-related complications in early and late follow-up were diarrhoea (n = 15), anal/perianal disorders (15), arthralgia (15), urinary calculi (16), cholelithiasis (5), severe flatulence (7), liver cirrhosis (5), intestinal tuberculosis (1), ileitis (1), severe electrolyte disturbance (4), hypomagnesaemia (22), hypokalaemia (8), and deficiency of vitamin B12 (24), iron (24) and folate (17). Although jejunal bypass effectively reduces weight, the patients are at continuous risk of many complications. However, the improvement in quality of life should not be underestimated.
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PMID:Jejunoileal bypass for morbid obesity. Report of a series with long-term results. 259 48

The operation consisting of abdominal colectomy, proximal proctectomy, distal mucosal proctectomy, and ileal pouch-anal anastomosis eliminates colorectal mucosal disease, restores transanal defecation, and avoids the need for a permanent abdominal stoma and the wearing of an external appliance. During the 4-year period from January 1981 through December 1984, 369 such operations were done at the Mayo Clinic for either ulcerative colitis (in 336 patients) or polyposis coli (in 33 patients). None of the patients died in the immediate postoperative period. Follow-up data for the initial 188 patients showed the following complications: anastomotic stricture in 12%, pelvic sepsis in 11%, obstruction of the small intestine in 9%, and reservoir ileitis in 7%. A permanent stoma had to be established in 5% of patients. All patients could defecate spontaneously, and 95% had satisfactory continence for stools and gas. This operation seems safe and effective and provides a quality of life superior to that seen after the conventional Brooke ileostomy.
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PMID:Restorative proctocolectomy and ileal reservoir. 395 Dec 58

The frequency of human infections caused by Campylobacter (C.) jejuni is thought to be at present as significant as that of the gastroenteric salmonelloses. The clinical symptoms are mostly like enteritis, enterocolitis, acute abdomen or ileitis terminalis. Post-infection reactions are possible not only as arthritis or septicemia but also as meningitis, conjunctivitis, carditis, pneumonia, cholecystitis, peritonitis, urinary tract infection and abortion. Only cultural examinations confirm the diagnosis of an infection with C. jejuni. If chemotherapy is required, erythromycin is the remedy of choice. Animals are an important reservoir for C. jejuni, but the epidemiology of human infections with this microorganism is not well understood.
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PMID:[Campylobacter jejuni--a "recent" pathogen worthy of study. Present knowledge on its clinical aspects, diagnosis, therapy and epidemiology]. 675 59

Enteral yersiniosis is caused either by Y. enterocolitica 0-group I (syn. serotype 0:3) and 0-group V (syn. serotype 0:9) or Y. pseudotuberculosis type I-VI. The clinical symptoms are mostly like enteritis, enterocolitis, acute abdomen, mesenteric lymphadenitis, or ileitis terminalis. Post-infection reactions are possible like septicemia, arthritis and erythema nodosum. Only cultural and serological examinations confirm the diagnosis of enteral yersiniosis. In the judgement of serological results it is necessary to consider the cross-reactions of Y. enterocolitica 0-group V to Brucella abortus, Brucella melitensis and Brucella suis and also to the antigenic community of Y. pseudotuberculosis type II respectively IV to Salmonella group B respectively D. With exception of septicemia, it is not necessary to treat enteral yersiniosis with antibiotics.
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PMID:[Enteral yersiniosis--a serious disease? Current knowledge of clinical aspects, diagnosis and therapy]. 709 94

An overview of a series of patients treated for peritonitis over the last 5 years showed that in 64 cases (6.8%) the infection was due to a non traumatic perforation of small intestine. The predominant aetiology was typhoid fever (39 cases), other causes for the peritonitis were perforation of an abdominal diastasis (10 cases) or a Meckel's diverticulum (8 cases), and perforation due to an acute ileitis (2 cases), a non Hodgkins malignant lymphoma (2 cases), a necrotizing enteritis (2 cases) and a jejunal tuberculoma (1 case). The surgical attitude to be adopted for repair of the perforated loop is dependent on the aetiology and the degree of peritoneal sepsis. Enterostomy should be performed as a safety measure in patients with perforation due to typhoid fever.
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PMID:[Non-traumatic perforation of the small intestine]. 840 29

The clinical presentation, course and outcome of Yersinia enterocolitica infection was studied prospectively in 125 children. Enteric forms occurred in 114 children (92 enteritis, 20 pseudoappendicitis, 2 chronic ileitis), of whom 17 also had extramesenteric manifestations; 11 children had one or more extramesenteric forms without enteric disease. Enteritis occurred more frequently in young children whereas serious forms and extramesenteric forms were more common in children older than 6 years of age (P < 0.001). Arthritis was observed in 13 children and extensive lymphadenopathy in 11; 1 child had septicemia with pleurisy, 1 had vasculitis, 1 had cholecystitis and 4 had erythema nodosum. Diagnosis was established by positive culture in 100 (80%) children and by agglutinin test in 11 of 45 (24%), demonstration of circulating specific anti-IgA and anti-IgG to Yersinia outer membrane proteins in 47 of 48 (98%) and detection of antigen in biopsies in 28 of 33 (85%) children. The 2 latter methods were superior to the agglutinin test. Serotype O3 and O9 predominated. The frequency and seriousness of complications may justify the use of antibiotics for Yersinia enteritis in children 6 years of age or older.
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PMID:Yersinia enterocolitica infection in children. 855 26

In this study, we investigated the colonizing ability as well as the association of Yersinia enterocolitica serotype 0:9 to epithelial cells of the intestinal tract, Peyer's patches, mesenteric lymph nodes, liver, spleen and lungs in Alloxan-induced diabetes mellitus in mice and controls. The results showed that: (a) in diabetic mice the Y. enterocolitica colonizing values were in range of 10(6.5)-10(8.25) CFU/g of feces; (b) maximum colonizing values were found in distal ileum and Peyer's patches and lower in colon; (c) the infection was progressive with dissemination of bacteria in the liver, spleen and lung; (d) in control (non-diabetic) mice, the colonizing values were 10-100 times lower than those found in the diabetic batch; (e) the main histopathological changes noticed, namely ileitis, mesenteric lymphadenitis and septicemia, were presumably induced by high bacterial load in the liver, spleen and lung leading to a septic course of infection as well as toxic effects of heat-stable enterotoxins of Y. enterocolitica (Yst). The results were confirmed by electron microscopy observations. Summing up, these results demonstrate that diabetic mice were more susceptible to Y. enterocolitica cells than normal mice.
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PMID:Studies on pathogenicity of Yersinia enterocolitica in mice with diabetes mellitus. 1184 54

Yersinia enterocolitica and Y. pseudotuberculosis are causative agents of yersiniosis in humans and animals that have to be separated from Y. pestis, the causative agent of plague, representing a separate clinical and epidemiological entity. Intestinal yersiniosis may manifest in humans as (1) enteritis, (2) terminal ileitis, mesenteric lymphadenitis, or pseudoappendicitis, and (3) septicemia leading to focal abscesses in spleen and liver. The intestinal infection may be followed by reactive arthritis in a number of cases. Y. enterocolitica and Y. pseudotuberculosis are distributed worldwide but occur mainly in moderate or subtropical climates. The most important reservoirs are rodents, lagomorphs, and birds for Y. pseudotuberculosis and domestic animals, especially pigs, for Y. enterocolitica. All Y. pseudotuberculosis isolates may be considered as pathogenic whereas Y. enterocolitica strains can be subdivided into pathotypes of different virulence. The differentiation of pathotypes by determination of the biovar and demonstration of the 75-kb virulence plasmid is therefore of diagnostic importance. Preventive measures include avoidance of direct infection by contact with infected reservoir animals and practice of good hygiene during slaughtering as well as in food production and preparation of meals.
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PMID:[Intestinal yersiniosis. Clinical importance, epidemiology, diagnosis, and prevention]. 1525 24


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