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

In 258 patients, neurological symptoms of otogenic leptomeningitis and diagnostic importance of the meningeal symptom-complex in the clinical development of other intracranial complications and sepsis were investigated. Otogenic leptomeningitis was characterized by the meningeal syndrome, rigidity of occipital muscles combined with Brudzinski's sign and Kernig's sign, albumin-cytologic dissociation in the cerebrospinal fluid, and, frequently, unilateral lesion of cranial nerves. Meningeal symptoms in the case of cerebrum and cerebellum abscesses did not always indicate leptomeningitis. Kernig's sign and its combination with occipital muscle rigidity can be an indication of cerebrum abscesses. With leptomeningitis and cerebrum abscesses, the rigidity of occipital muscles rarely occurs as a separate symptom, which emphasizes its importance in the topical diagnosis of subtentorial abscesses.
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PMID:[Diagnostic evaluation of meningeal syndrome in otogenic intracranial complications and infection]. 226 95

The pathogenicity of Haemophilus parasuis for mice and guinea pigs was examined. Mice were inoculated intraperitoneally with 2 X 10(7) to 2 X 10(9) organisms suspended in saline or in broth containing fresh yeast extract. Most of them survived after inoculation. Death occurred only in mice inoculated with 2 X 10(9) organisms suspended in broth. The recovery rate of H. parasuis from all the dead mice varied from 28.9% of the brains to 71.4% of the lungs. There were no lesions observed in any mouse, except one. Guinea pigs were inoculated intraperitoneally with 1 X 10(8) to 1.6 X 10(10) organisms suspended in saline. Many of them died after showing septicemia and serofibrinous serositis, which were associated with purulent leptomeningitis or meningoencephalitis in some of them. H. parasuis was recovered abundantly from many organs, including the brain, in the guinea pigs. It was also recovered from guinea pigs inoculated with 1.8 X 10(9) organisms by various routes. Serositis was observed in guinea pigs inoculated intramuscularly or intrapulmonarily. These results suggested that guinea pigs might be available for investigation of the pathogenicity of H. parasuis.
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PMID:Experimental infections of mice and guinea pigs with Haemophilus parasuis. 707 59

Candidosis is the most common postmortem cerebral mycosis, yet is rarely appreciated clinically. From 8975 complete autopsies, 41 patients were identified with tissue verified deep candidosis. Nineteen of them (46 per cent) had cerebral candidal infections. There were eight males and 11 females, and 15 whites and four blacks. The age varied from 17 days to 82 years, with a mean age of 40 years. Cancer was observed in four (21 per cent). All 19 individuals had proven or suspected gram negative sepsis and had been treated with appropriate antibiotic therapy. Other predisposing factors included major surgery (63 per cent), steroid therapy (53 per cent), and deep venous lines (42 percent). Candida species was identified outside the brain in every patient and included the kidneys (90 per cent), heart (80 per cent), and other organs. Portals of entry appeared to be the gastrointestinal tract, deep venous lines, or both. In this autopsy population, candidosis occurred only in compromised patients and produced intracerebral microabscesses and noncaseating granulomas without diffuse leptomeningitis. Cerebral lesions occurred late in the disease, and were complicated by cardiac and renal candidosis, which contributed to the patient's death. With an increased awareness of the appropriate clinical setting, this iatrogenic mycosis can be handled properly and prevented from jeopardizing the patient.
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PMID:Human cerebral candidosis--a postmortem evaluation of 19 patients. 720 51

We report a rapidly fatal Bacillus cereus septicemia in a leukemic patient receiving remission-induction therapy. Symptoms resembling food poisoning and fever preceded coma accompanied by neurologic abnormalities. Autopsy revealed necrotizing leptomeningitis with subarachnoid hemorrhage and coagulation necrosis of the liver with bacterial infiltration. These clinicopathologic findings were closely similar to those of reported cases. Because of a rapidly fatal clinical course, suspicion of this syndrome early in the course is important to determine an appropriate treatment. Therefore, we propose that this type of septicemia should be termed as fulminant septicemic syndrome of Bacillus cereus.
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PMID:Fulminant septicemic syndrome of Bacillus cereus in a leukemic patient. 914 19

Group B streptococcus is a possible cause of chorioamnionitis, endometritis and urinary tract infections in pregnant woman. Maternal risk factors and the vertical transmission of GBS and neonatal GBS infection occur through the following fever during labor, the rupturing of membranes more than 18 hours before delivery, prematurity and chorioamnionitis. GBS can induce early-onset neonatal disease (sepsis, meningitis or pneumonia) during the first week of life and late-onset neonatal infection (leptomeningitis) within the first 12 weeks of life. Numerous strategies for preventing neonatal group B streptococcal infection were investigated: 1) the treatment of GBS-colonized women during the third trimester of pregnancy did not prove to be effective because it does not reduce maternal colonizzation rates at delivery; 2) the neonatal universal post-partum prophylaxis with penicillin G was ineffective and increased neonatal mortality due to penicillin-resistant bacterial infection; 3) the intrapartum maternal chemoprophylaxis with penicillin G or ampicillin in GBS-colonized women, in women with risk factors, or in women with both GBS colonization and risk factors. The latter strategy proved to be the most effective because it reduces the risk of early-onset GBS infection by 75% and 95% when associated with post-neonatal prophylaxis. To date, there are no guidelines on the management of the asymptomatic neonate whose mothers have been treated with chemopropylaxis intra-partum.
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PMID:[Prophylaxis of group B beta-hemolytic streptococcal infections]. 1142 3

The dermatology staff was called to evaluate abnormal hair on a 22-month-old Hispanic girl whose parents were first cousins. Her medical history was significant for leptomeningitis with subsequent neurologic devastation, gastroesophageal reflux disease, and recurrent respiratory infections. Her hospital course was complicated by sepsis, liver dysfunction, pan-cytopenia, and disseminated intravascular coagulation. She had developed normally for the first year of life. At 13 months she became progressively lethargic and developed floppy muscle tone; a delay in mental and motor milestones was recognized. Results of a metabolic workup were negative. On examination she was noted to have generalized excessively fair skin when compared with her parents. She had silver-gray hair (Figure 1) and white eyebrows and body hair. Her maternal grandfather and granduncles had silver hair since childhood, but were without health problems. A maternal family member was said to have light skin. The presumed diagnosis before pathologic examination was Chediak-Higashi syndrome. Hematoxylin and eosin stain tests revealed prominent melanocytes in the basal layer of the epidermis. The melanocytes were large and distended with a large volume of melanin (Figure 2). The adjacent keratinocytes were completely devoid of melanin. Application of Masson-Fontana ammoniac silver stain highlighted prominent melanocytic melanin and a relative paucity of melanin in the adjacent keratinocytes (Figure 3). Microscopic examination of her hair revealed clumps of melanin of various sizes and shapes irregularly distributed throughout the hair shaft. Ultrastructural examination of the epidermis showed the melanocytes were distended by an accumulation of large stage IV mature melanosomes. Peripheral blood smear failed to show abnormal granules, even after repeated examination. Based on the clinical features and the pathologic findings, a diagnosis of Griscelli syndrome type 2 was made.
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PMID:Griscelli syndrome. 1748 61

Lemierre syndrome is a distinct clinical syndrome comprising oropharyngeal sepsis and fever, internal jugular vein thrombosis and remote septic metastases caused by Fusobacterium species. The mortality rate was historically high and although use of antibiotics led to a dramatic fall in incidence, a resurgence has been seen recently. A 14-year-old male developed Lemierre syndrome after tonsillitis. There was extensive leptomeningitis, especially over the clivus, causing 6th and 12th cranial nerve palsies, a clinical feature termed the 'clival syndrome'. He also developed an epidural abscess in the cervical spine, which was unsafe for surgical drainage. Conservative treatment with an extended course of antibiotics and anticoagulation for jugular vein thrombosis led to a good recovery. A 15-year-old female developed Lemierre syndrome after a persistent sore throat lasting 7 weeks. She had palsy of the 12th cranial nerve from clival osteomyelitis. She was treated with a 6-week course of antibiotics and anticoagulants leading to almost full recovery at 3-month review. Awareness of the potential neurological complications of Lemierre syndrome and prompt management are crucial in reducing morbidity and mortality in this 'forgotten disease'.
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PMID:Neurological complications in two children with Lemierre syndrome. 2058 47

Histophilus somni is responsible for sporadic disease worldwide in cattle and, to a lesser extent, in small ruminants, bighorn sheep (Ovis canadensis), and North American bison (Bison bison). The importance of H. somni diseases can be attributed to improved clinical and laboratory recognition, combined with the growth in intensive management practices for cattle. Although outbreaks of bovine histophilosis can occur year-round, in northern and southern hemispheres, it is most frequent in late fall and early winter. Weather, stress, dietary changes, and comingling of cattle are likely to be major triggers for outbreaks. The most frequent clinical expressions of histophilosis include undifferentiated fever, fibrinosuppurative pneumonia, encephalitis-leptomeningitis, necrotizing myocarditis, and diffuse pleuritis. Neurological disease occurs either as thrombotic meningoencephalitis (TME) or as suppurative meningitis with ventriculitis. Acute myocarditis is characteristically necrotizing and generally involves one or both papillary muscles in the left ventricular myocardium. Biofilm-like aggregates of bacteria occur in capillaries and veins in myocardium, in the central nervous system, and on endocardial surfaces. H. somni is a component of bovine respiratory disease (BRD) complex. In our experience, it is most commonly diagnosed in subacute-to-chronic polymicrobial pulmonary infections in combination with Mannheimia haemolytica, Trueperella pyogenes, Pasteurella multocida, or Mycoplasma bovis. Other, less common forms of H. somni disease present as polyarthritis/tenosynovitis, abortion with placentitis and fetal septicemia, epididymitis-orchitis, and ocular infections. It is likely that H. somni is under-recognized clinically and diagnostically. Most state and provincial laboratories in North America rely on bacterial isolation to confirm infection. The use of more sensitive detection methods on field cases of histophilosis will help resolve the pathogenesis of H. somni in natural outbreaks, and whether the disease is as common elsewhere as it is in Canada.
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PMID:Histophilosis as a Natural Disease. 2684 57

We investigated deaths in a group of feedlot steers in Argentina. The main findings in 3 steers autopsied were pulmonary congestion and edema, necrotizing myocarditis, pericarditis, suppurative leptomeningitis, and bronchopneumonia. Histophilus somni was detected by bacterial culture and immunohistochemistry in the hearts of the 3 animals. Partial sequences of the 16S rRNA gene of a H. somni isolate had 99% similarity with other H. somni sequences in GenBank. Most reports of H. somni septicemia in cattle originate from North America and western Europe. There is scant information about cardiac histophilosis in South America. A survey of diagnostic laboratory personnel in 7 South American countries documented various forms of bovine histophilosis in Argentina, Brazil, Uruguay, and Venezuela.
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PMID:Histophilus somni myocarditis and leptomeningitis in feedlot cattle: case report and occurrence in South America. 3164 58