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

Penicillin allergy presents a major obstacle to the successful management of some antepartum infections. We studied 15 pregnant women with histories of penicillin allergy confirmed by positive immediate wheal-and-flare skin tests. Thirteen had syphilis, one listeria sepsis, and one Streptococcus viridans endocarditis. Each patient was desensitized over four to six hours by oral administration of increasing doses of penicillin V. At the completion of the procedure, full-dose parenteral therapy with penicillin G or ampicillin was instituted. No extracutaneous reactions were detected. Five of the subjects (33 per cent) experienced pruritus (three) or urticaria (two), but no interruption of desensitization or therapy was necessary. All clinically apparent maternal infections were cured. The pregnancy complicated by listeriosis aborted in the first trimester. The 11 neonates delivered to date are normal. These results indicate that oral desensitization is an acceptably safe approach to therapy in pregnant women who are allergic to penicillin and have infections that require beta-lactam drugs.
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PMID:Penicillin allergy and desensitization in serious infections during pregnancy. 392 35

The AA describe a case of neonatal sepsis caused by Listeria monocytogenes observed in their Intensive Care Unit. The preterm neonate, born at the 30th week of gestational age, died after three days, showing clinical signs of sepsis and severe respiratory distress. Although the anamnesis of the mother revealed an episode of fever one month before delivery, the origin of which was not identified, it was not possible to isolate the Listeria in the mother. The AA discuss some clinical and therapeutical aspects of listeriosis; this infection is not very frequent in Italy, nevertheless it should not be underestimated either in the mother or in the neonate.
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PMID:[A case of neonatal listeriosis]. 409 23

Between 1951 and January 1972 listeriosis was diagnosed bacteriologically in 101 Canadian patients. This study adds 80 cases to the 21 reported from Metropolitan Toronto by Sepp and Roy in 1963. The Laboratory Centre for Disease Control, Ottawa, collated epidemiological and clinical data. Serotypes of Listeria monocytogenes included 4b (53), 1 (15), 1b (6), 1a (2), 2 and 3. Clinically, 54 patients had meningitis and 23 septicemia. The mortality rate was 30%.Between 1954 and January 1972 listeriosis affected 15 British Columbian patients: nine were male and six female; 12 were less than 1 or more than 45 years old. Among the patients were a pregnant mother and the son to whom she gave premature birth. A day-old infant and an elderly man died.
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PMID:Listeria monocytogenes infections in Canada. 419 95

Inadequate guidelines for the treatment of neonatal listeriosis led us to evaluate various antibiotics in a newborn rat model of Listeria monocytogenes type 4b sepsis. Minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC based on 99.9% killing), expressed as micrograms/ml, were determined for: ampicillin (MIC 0.46/MBC 3.20); ampicillin with subinhibitory concentrations of gentamicin (0.24/not done); erythromycin (0.14/3.59); gentamicin (0.38/1.11); gentamicin with subinhibitory concentrations of ampicillin (0.235/ND); piperacillin (2.7/16.8); rifampin (0.026/0.094); sulfamethoxazole (SMZ 47.5/ND); SMZ with subinhibitory concentrations of trimethoprim (0.74/1.48); trimethoprim (TMP 0.12/ND); and TMP with subinhibitory concentrations of SMZ (0.04/0.08). In the in vivo model, rats were challenged intraperitoneally with 2 X 10(6) cfu of L. monocytogenes at 3 days-of-age. Antibiotics (ampicillin, ampicillin + gentamicin, erythromycin, piperacillin or TMP/SMZ) were given every 12 h for 2 days starting on day 5 of life while rifampin was given once daily for 2 days. Survival tabulations and spleen cultures were done on day 8 of life. All animals who received antibiotics had better survival than the controls given saline (p less than 0.01 for rifampin, erythromycin, TMP/SMZ, ampicillin, ampicillin + gentamicin; p less than 0.05 for piperacillin). Rifampin, erythromycin and TMP/SMZ gave better survival than piperacillin (p less than 0.01). Although ampicillin plus gentamicin were superior to ampicillin alone (p less than 0.01) in reducing the number of organisms in the spleens, rifampin was superior to all regimens in this regard (p less than 0.0005 vs piperacillin, ampicillin, TMP/SMZ; p less than 0.05 vs ampicillin + gentamicin, erythromycin). Rifampin may be a useful addition to other regimens in speeding the elimination of the organism.
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PMID:In vitro and in vivo activity of various antibiotics against Listeria monocytogenes type 4b. 644 56

Infection with Listeria monocytogenes during pregnancy has a high fetal and neonatal mortality. In rodents, it has been shown that resistance to Listeria infection is dependent upon a T cell-mediated immune response to the bacteria. The immune humoral and cell-mediated response to L. monocytogenes was studied in seven mother infant pairs who had documented evidence of L. monocytogenes sepsis. All studies were carried out 1 year following the initial infection as part of a clinical and immunological follow-up, and compared to an appropriate control group. The microagglutination titre and opsonizing activity of mothers previously infected with Listeria was significantly greater than that of the control mothers or their infected infants. There was no difference between the babies previously infected with L. monocytogenes when compared to control infants. The in vitro lymphoblastogenic response to Listeria, staphylococci, tetanus toxoid, and phytohemagglutinin was assessed. Infected mothers had a significantly greater proliferative response in the presence of Listeria than the control mothers, while the response of the previously infected infants was not different from that of the control infants. The response to the other antigens and PHA was similar in all groups. In conclusion, infants infected with L. monocytogenes during the perinatal period demonstrated neither a specific antibody response nor exhibited a cell-mediated immune response to this bacteria. These data support the idea that perinatally-infected infants have a markedly impaired immune response to L. monocytogenes and may, thus, explain their increased susceptibility to this infection.
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PMID:The immune response of human neonates to Listeria monocytogenes infection. 653 34

During the past twenty years 793 strains of Listeria monocytogenes were isolated from human beings in the Netherlands; of these 193 were taken from neonates and babies up to two months old. Isolations from adults came from patients (242) as well as clinically healthy people (358). Septicaemia appeared to occur to an equal extent in men and women (20 and 29 respectively), whereas meningitis was found more often in men than in women (50 and 22 respectively). A clear predisposition for L.m. develops after administration of immunosuppressive treatment and also in cases of liver disorders. Among veterinary surgeons listeriosis has been observed as an occupational disease. Isolations from animals have shown that L.m. may cause infections in every species of warm-blooded animal. Next to meningitis and abortus chronic and atypcial symptoms of the disease may be observed in animals. Epizootic spread of the disease has hardly ever been observed in the Netherlands. In clinically healthy humans and animals both the haemolytic and the non-haemolytic type of L.m. have been isolated from feces; as regards the latter type it is very questionable whether it has any pathogenic significance. When inoculating 10 days old hen's eggs the haemolytic strains will kill all embryo's within 4 days whereas all embryo's inoculated with non-haemolytic strains will survive. Both types of strains have also been isolated from waste- and surface waters. As regards epidemiological and epizootiological aspects the conclusion is warranted that continued research will be needed to get a clear picture of the course of infection of L.m. When isolating strains from contaminated material the so-called cold enrichment icubation at 4 degrees C continues to be of great value; in the course of our experiments the nalidixic-acid trypaflavine serum agar proved to be a very good selective medium. A number of stable biochemical reactions of L.m. are rather characteristic (salicine+, galactose-) but provide no clue to distinguish between haemolytic and non-haemolytic strains.
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PMID:Listeriosis in humans and animals in the Netherlands (1958-1977). 677 41

Human beings are frequently exposed to Listeria monocytogenes, but these microorganisms are rarely pathogenic for healthy subjects. In recent years an increase in the frequency of listeriosis has been reported, especially in patients with severe underlying diseases. In the present work the clinical, microbiological, therapeutic and prognostic characteristics of seven adult cases of listeriosis are reviewed. L. monocytogenes was isolated from blood, cerebrospinal fluid or both. Most patients had an underlying illness (one alcoholic, one diabetic, one lymphoma, and two aplastic anemia), and three of them had received immunosuppressive treatment. The disease can have different clinical presentations; the commonest forms were septicemia and acute meningitis. All patients with an underlying disease succumbed to listeriosis. A comment is made on the possibility of confusion between L. monocytogenes and other germs, and some aspects of the epidemiology of listeriosis are analyzed.
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PMID:[Listeriosis in the adult: report of 7 cases]. 678 95

The most common forms of Listeria monocytogenes infection in adults are meningitis-encephalitis and sepsis. Infection of the pulmonary parenchyma and pleura have rarely been reported. A case of listeria meningitis presenting with pleural space infection in an immunosuppressed patient is presented and a review of 5 additional patients with listeria infection of the respiratory tract is included. All 6 patients described in this report had L. monocytogenes infections presenting with respiratory tract symptomatology, although 4 patients subsequently had positive blood or cerebrospinal fluid cultures. It is emphasized that a culture report of 'diphtheroids' from a thoracentesis specimen should not be automatically dismissed as contamination, particularly in an immune compromised patient.
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PMID:Pleural-pulmonary aspects of Listeria monocytogenes infection. 683 91

Fever of unknown origin in the pregnant woman presents special diagnostic, therapeutic, and obstetric problems. Two such clinically ill, febrile third-trimester patients, one presenting with maternal septicemia and transplacental fetal listeriosis and the other with borreliosis, are discussed. Although the neonatal outcome in such infections historically is poor, the infants of these mothers survived. It is suggested that special diagnostic procedures, timely administration of parenteral antibiotics, and vigilant antepartum testing be considered in all similar pregnant patients.
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PMID:Listeriosis and borreliosis as causes of antepartum fever. 686 69

Eight cases of materno-fetal listeriosis were discovered at the University Women's Hospital of Basel from May 1977 until June 1980. This represent an incidence of 0,15% of all births. This infectious disease has often a fatal course for the unborn child, therefore it is important to know the clinical manifestations occurring with it. Listeriosis during pregnancy has a typical-two-stage course: During the first phase we see commonly a flu-like illness abating rapidly, about two weeks later fever starts again and premature contractions ensue, but no therapy is successful in controlling the fever and the premature labour. The usual fate for the unborn child is stillbirth or premature delivery with subsequent neonatal death due to prematurity, RDS, sepsis and meningitis. The low fetal and neonatal survival rate can be improved by two relatively simple measures: 1) a high index of suspicion with early diagnosis, 2) an early treatment with ampicillin either in the antepartal or neonatal stage. We review the epidemiology, the bacteriology, the serology and the histo-pathology of this relatively rare but important disease during pregnancy.
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PMID:[Listeriosis during pregnancy (author's transl)]. 720 Jun 83


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