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

Intravascular haemolysis is a rare but serious complication of Clostridium perfringens sepsis. The outcome is usually fatal unless treatment is started early. We describe a case of survival after haemolysis and multiple organ failure in the setting of a ruptured liver abscess and sepsis caused by C. perfringens in an immunocompetent 58-year-old male.
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PMID:Intravascular haemolysis and septicaemia due to Clostridium perfringens liver abscess. 2086 84

Pyogenic liver abscess (PLA) is still associated with significant morbidity and mortality. With advances in imaging, most cases are now diagnosed early and effectively treated. However, complications, although considered rare, may still occur. We report three cases of PLA that were associated with rare and significant complications. Two patients had an abscess rupture that resulted in pyopericardium in one patient and sub-diaphragmatic abscess in the other. Another patient with Klebsiella pneumoniae PLA had bilateral endophthalmitis that resulted in blindness. Death secondary to overwhelming sepsis occurred in the patient with Escherichia coli-related pyopericardium. Delay in diagnosis contributed to the complications in two of the patients.
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PMID:Rare complications of pyogenic liver abscess. 2110 6

A liver abscess may arise following any insult to gut integrity allowing portal drainage of bacteria to hepatocytes. Foreign bodies such as bones, toothpicks and items of stationery have previously been implicated in compromising gut epithelium. Here we present the case of a 57 year old man suffering from a left liver abscess. This was defined on CT which incidentally also identified a chicken bone protruding through the wall of the distal sigmoid colon. Whilst unwell with upper abdominal pain and sepsis, the presumed source of portal sepsis within the colon remained asymptomatic throughout. Following percutaneous drainage, the liver abscess resolved but the chicken bone had not passed at two months, necessitating atraumatic removal at colonoscopy. A high rate of incidental diagnoses suggests that unidentified foreign bodies may be vastly under recognised in cases of hepatic sepsis. Thus, identification of the precise mechanism of the liver insult demands thorough consideration; foreign body should be considered in all cases.
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PMID:An unusual zoonosis: liver abscess secondary to asymptomatic colonic foreign body. 2111 88

Persistent nephrogram, the hallmark of radiocontrast-induced kidney failure, is usually homogenous throughout the kidney and is considered as a generalized shutoff of glomerular filtration, the consequence of altered glomerular hemodynamics, affecting most glomeruli. Herein, we report an incidental finding of scattered persistent nephrogram that was noted in a septic prediabetic hypertensive patient during computerized tomography-guided drainage of a liver abscess. The peculiar patchy striated distribution pattern suggests more centrally altered renal hemodynamics, with hypoperfusion at the level of interlobar and intralobular arteries. Altered renal microcirculation in this case is likely related to the combined effects of prediabetes, sepsis and contrast medium upon renal blood flow regulation, perhaps with consequent focal hypoxic tubular damage.
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PMID:Scattered striated persistent nephrogram in sepsis. 2141 76

Severe congenital neutropenia is a primary immunodeficiency; the lack of maturation of neutrophil precursor in bone marrow and severe neutropenia are the subjacent characteristics which explain a marked susceptibility to severe and recurrent infections; bacteria and fungi are the most common etiologic agents. We report the case of an infant with severe congenital neutropenia that began at 4 days from birth with perianal abscess infections, sepsis, liver abscess, gingivitis and oral ulcers; she required multiple hospitalizations because of the severity of the infections. Isolated agents were Pseudomonas aeruginosa, Staphylococcus hominis and Klebsiella sp. The bone marrow examination showed maturation arrest of myeloid forms, thus confirming the diagnosis of severe congenital neutropenia. Granulocyte colony-stimulating factor was started. The severe congenital neutropenia should be considered in patients with neutropenia and infections in the first month of life. Early diagnosis and treatment improve survival and quality of life of these patients.
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PMID:[Severe congenital neutropenia]. 2185 29

Lymphadenitis can be caused by different gram positive and gram negative bacteria and non-tuberculous mycobacteria. Cervical lymphadenitis in children is thought to result from ingestion of or contact with environmental microrganisms. Chromobacterium violaceum is a common inhabitant of soil and water in tropical and sub tropical countries. In these parts of the world Chromobacterium violaceum is able to cause skin infection with diffuse pustular lesions and also multiple liver abscess with often fatal evolution in sepsis. We describe a case of cervical lymphadenitis caused by Chromobacterium violaceum in a 14-year-old boy, born in Guinea and resident in Italy for 7 years in a fair condition with general measurable swelling in the right lateral cervical region and with blood tests that showed increased inflammatory indices. The patient was subjected to surgical incision. Antibiotic therapy with ceftriaxone was continued for 10 days, then replaced successfully with oral ciprofloxacin on the basis of purulent material culture positive for Chromobacterium violaceum sensitive to fluoroquinolones.
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PMID:Chromobacterium violaceum lymphadenitis successfully treated in a Northern Italian hospital. 2214 20

Lactococcus garvieae, an emerging zoonotic pathogen, is responsible for mastitis in rodents and sepsis in fish. Although deemed opportunistic and hardly ever causing infections in humans, its incidence is probably underestimated due to the difficulty in diagnosis. There are very few reports of osteomyelitis, liver abscess, and peritonitis, and only nine cases of endocarditis described in worldwide literature. We describe the first case of Lactococcus garvieae endocarditis in Latin America, in a female patient with metallic prosthetic heart valve who presented with daily fever, chills, Osler nodes and six positive blood cultures for Lactococcus garvieae, which met Duke's criteria for the diagnosis of "definitive infective endocarditis"
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PMID:Lactococcus garvieae endocarditis: first case report in Latin America. 2218 14

We report a rare case of 17-day-old neonate, diagnosed to have ruptured liver abscess secondary to Methicillin-resistant Staphylococcal aureus infection. The child presented with septicemia and abdominal distension. On exploration, there was pyoperitoneum with ruptured liver abscess.
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PMID:Ruptured liver abscess in a neonate. 2238 13

Klebsiella pneumoniae is the common cause of a global emerging infectious disease, community-acquired pyogenic liver abscess (PLA). Capsular polysaccharide (CPS) and lipopolysaccharide (LPS) are critical for this microorganism's ability to spread through the blood and to cause sepsis. While CPS type K1 is an important virulence factor in K. pneumoniae causing PLA, the role of LPS in PLA is not clear. Here, we characterize the role of LPS O antigen in the pathogenesis of K. pneumoniae causing PLA. NTUH-K2044 is a LPS O1 clinical strain; the presence of the O antigen was shown via the presence of 1,3-galactan in the LPS, and of sequences that align with the wb gene cluster, known to produce O-antigen. Serologic analysis of K. pneumoniae clinical isolates demonstrated that the O1 serotype was more prevalent in PLA strains than that in non-tissue-invasive strains (38/42 vs. 9/32, P<0.0001). O1 serotype isolates had a higher frequency of serum resistance, and mutation of the O1 antigen changed serum resistance in K. pneumoniae. A PLA-causing strain of CPS capsular type K2 and LPS serotype O1 (i.e., O1:K2 PLA strain) deleted for the O1 synthesizing genes was profoundly attenuated in virulence, as demonstrated in separate mouse models of septicemia and liver abscess. Immunization of mice with the K2044 magA-mutant (K(1) (-) O(1)) against LPS O1 provided protection against infection with an O1:K2 PLA strain, but not against infection with an O1:K1 PLA strain. Our findings indicate that the O1 antigen of PLA-associated K. pneumoniae contributes to virulence by conveying resistance to serum killing, promoting bacterial dissemination to and colonization of internal organs after the onset of bacteremia, and could be a useful vaccine candidate against infection by an O1:K2 PLA strain.
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PMID:Lipopolysaccharide O1 antigen contributes to the virulence in Klebsiella pneumoniae causing pyogenic liver abscess. 2242 76

Liver abscess in the pediatric population remains uncommon in developed countries, except in cases of septicemia or in children with major debilitating diseases, granulocyte dysfunction, or immunosuppression. Although much is known about the etiopathogenesis of liver abscess, the gold standard of investigations and treatment is still debatable in developing countries. We report the case of a 6-year-old child living in Reunion Island, with no medical history, presenting with right and pyretic abdominal pain in the right upper quadrant. Ultrasound and CT scan showed a large hypodense nonenhanced area in segment IV. Final diagnosis was, by exclusion, pyogenic liver abscess based on negative serology, recent liver lesion, and normal tumor test results, even if blood culture remained negative. No percutaneous puncture was done because of positive outcome after 4 days of antibiotics. Treatment consisted in three intravenous antibiotics (ceftriaxone, aminoxide, and metronidazole) until complete biological normalization. Ultrasound remained normal 3 months later. Even if liver abscess is uncommon in developing countries, the diagnosis must be raised in cases of isolated liver tumor with fever. Management in the nonimmunosuppressed child must be discussed associating parenteral antibiotic therapy, percutaneous drainage, or surgery in very uncommon cases, according to the liver location and first day's progression. Etiological investigation such as colonoscopy in adults must be adapted to pediatric data.
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PMID:[Management of pediatric liver abscess]. 2246 54


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