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

Pasteurella multocida is an unusual cause of septic arthritis with most patients having underlying joint damage or altered host defenses. We report 2 cases of polyarticular sepsis with this bacteria. Predisposing factors in our patients included alcoholic cirrhosis, end stage renal disease and metastatic malignancy. Heightened awareness of this organism's involvement in polyarticular septic arthritis in the immunocompromised patient is emphasized.
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PMID:Pasteurella multocida polyarticular septic arthritis. 359 5

Serratia plymuthica was isolated from the blood and from a central venous catheter tip in a 54-year-old man with alcoholic cirrhosis and clinical signs of sepsis. This was the seventh reported isolate of S. plymuthica from a clinical specimen and the first in which the organism was clearly a significant pathogen.
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PMID:Serratia plymuthica sepsis associated with infection of central venous catheter. 362 50

Nine cases of pleuro-pulmonary infection due to Pasteurella multocida were observed over an 11 year-period (1974-1984) occurring in seven men and two women, with a mean age of 65 (range: 47-80 years). There were 4 pneumonias and 5 cases of empyema, occurring on three occasions after septicemia. There was a background of depressed immunity in 7 cases: alcoholic cirrhosis (4 cases), blood dyscrasias (2 cases), breast cancer (1 case); and of a chronic broncho-pulmonary pathology in two cases. Animal inoculation was present in six cases but only one case of pneumonia followed injury by an animal (cat scratch). The clinical, radiological and epidemiological data of these nine cases were similar to those in the literature (forty-five published cases). There was a zero mortality in our (from 30%) in the literature. Pasteurella multocida is an opportunistic organism, noncommensal in man, producing pulmonary infections in subjects with generalised or localised diminished resistance, the portal of entry being airborne (indirect animal contact) or haematogenous. The organism is nearly always sensitive to Penicillin and other B-lactamines. The gravity of infections to Pasteurella multocida relates to the degree of decompensation or severity of the underlying disorder.
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PMID:[Pleuropulmonary disease caused by Pasteurella multocida. Study of 9 cases. Review of the literature]. 378 27

A Denver peritoneovenous (PV) shunt was inserted in 54 consecutive patients for relief of malignant (24 patients) or cirrhotic (30) refractory ascites. The median age of both groups was 58 years, and the most frequent diagnoses were gastrointestinal (15) or ovarian (7) cancers and alcoholic cirrhosis (25). Median survival time was 1.7 and 3.5 months (range, 0.1-15.5 and 0.1-50.5), and the 1-month mortality 42% and 27%, respectively. Postoperative 24-h urinary output increased by 2-31, and the 1-week weight reduction was 8 and 11 kg, respectively, compared with before shunting. Complete shunt failure was encountered early in two patients, due to catheter malposition and clotting. Four more patients experienced transient failure, for an early dysfunction rate of 11%. A shunt-related operative mortality of 6% was caused by pulmonary oedema (two patients) and sepsis (one patient). Shunt malfunction intervened in almost half (6 of 14) of the cancer patients surviving 1 month but was relieved in all but 1. In 3 of 22 cirrhotic 1-month survivors, the Denver shunt had to be removed owing to clotting or sepsis (2 patients) or revised because of blockage. Seven patients with cirrhosis are alive a median of 18 months (range, 2-51) after PV shunt surgery. Side effects were detected in 22 patients (41%): thromboembolism (9 patients), sepsis (7), initially bleeding oesophageal varices (3), DIC syndrome (2), postoperative hepatic coma (2), ascitic leakage (2), and pulmonary oedema (2). Patients with gastrointestinal cancers or severe cardiac disease did not benefit from the procedure. A history of hepatic encephalopathy or a serum bilirubin level above about 100 mumol/l was a bad prognostic sign. We could confirm the reported considerable morbidity and mortality after PV shunting, but also its efficiency in certain cases. Careful patient selection and follow-up study, timing of operation, and adherence to technical details are mandatory to improve the results.
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PMID:Denver peritoneovenous shunting for malignant or cirrhotic ascites. A prospective consecutive series. 380 91

Two patients with alcoholic cirrhosis were seen on two separate occasions for fever, swollen legs, petechial hemorrhage, purpura, and cutaneous bullae. One patient ate oysters 2 days before the onset of illness. Vibrio vulnificus, a lactose-positive halophilic vibrio, was isolated from the ascitic and cutaneous fluid in both cases, and from the blood in one of the two cases. Both isolated strains were sensitive to the antibiotics given to the patients from the beginning; however, both patients died, one from septicemic shock and the other from massive esophageal variceal hemorrhage. Autopsies in both patients revealed alcoholic cirrhosis, hemorrhagic necrosis of the terminal ileum, intraalveolar hemorrhage, petechial hemorrhage in the peritoneum, and nonspecific acute inflammation of the dermis with vasculitis. Physicians should consider V. vulnificus in the differential diagnosis of cirrhotic patients with sepsis, primary skin lesions, and spontaneous bacterial peritonitis with or without history of recent oyster ingestion.
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PMID:Spontaneous Vibrio vulnificus peritonitis and primary sepsis in two patients with alcoholic cirrhosis. 389 20

We describe two patients with alcoholic cirrhosis in whom staphylococcal right-sided endocarditis developed after insertion of a peritoneovenous shunt (PVS). Massive pulmonary embolism caused early death in one patient. In the other patient, staphylococcal septicemia was cured after shunt removal and antibiotic treatment; recurrent endocarditis due to Corynebacterium xerosis ultimately caused the patient's death. No clinical manifestation of tricuspid valve dysfunction was noted in either patient, and right-sided endocarditis was recognized only at autopsy. The protracted contact of the tip of the venous line of PVS with the atrial wall is likely to be a major factor in the development of right-sided endocarditis in these patients.
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PMID:Right-sided endocarditis complicating peritoneovenous shunting for ascites. 661 6

A 54-year-old male with alcoholic liver cirrhosis and hepatic coma grade IV is described, who succumbed as a result of spontaneous rupture of the spleen. A relationship to portal hypertension is suggested, although haemorrhagic diathesis and sepsis may have been contributing factors.
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PMID:Spontaneous rupture of the spleen complicating portal hypertension. 661 1

Peritoneovenous shunts (LeVeen) were placed in 52 patients with intractable ascites due to alcoholic cirrhosis between March 1975 and June 1978. The ascites was defined as intractable if it persisted despite at least six weeks of in-hospital medical management. Only 4.5% of such patients seen during this interval met this criterion by failing to respond to intensive drug and diet therapy. Eight (15%) died five to 60 days postoperatively; six of these did not undergo diuresis. Hepatic encephalopathy and sepsis were important contributing factors. There were 21 late deaths (mean survival, 16 months), primarily related to complications characteristic of this group of cirrhotics: upper gastrointestinal hemorrhage and infection. Twenty-three patients were alive by June 25, 1980, with mean survival of 46 months. Four patients operated on five or more years ago survive without ascites. An accurately placed LeVeen shunt dramatically relieves intractable ascites with improvement in renal function, nutrition, and general health. The operation enables at least partial rehabilitation so that ambulatory care becomes feasible for many of these chronically and seriously disabled patients.
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PMID:Intractable ascites treated with peritoneovenous shunts (LeVeen). A 24- to 64-month follow-up of results in 52 alcoholic cirrhotics. 723 44

We report a case of spontaneous peritonitis due to Candida albicans, in a diabetic patient with alcoholic liver cirrhosis, ascites, gastrointestinal bleeding from esophageal varices, sepsis, renal failure and encephalopathy. These factors, added to prolonged antibiotic therapy and instrumental manipulations, could have resulted in the colonization by Candida, usually described in secondary peritonitis, but perhaps underdiagnosed in cirrhotic patients with spontaneous peritonitis and severe multiorgan failure.
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PMID:[Ascitic peritonitis due to Candida albicans]. 798 5

We report two cases of ischemic hepatitis in patients with alcoholic cirrhosis. In both, hepatic ischemia was induced by hemorrhagic shock and severe sepsis. Despite control of the bleeding and restoration of normal hemodynamics, liver failure deteriorated to hepatic coma and death in both cases. Ischemic hepatitis occurred in 1.5% of 130 consecutive cases of cirrhosis admitted for hemorrhage on our medical intensive care unit. Although cirrhotic patients run an increased risk of ischemic hepatitis, our experience and our review of the literature indicate that this condition is rare in these patients.
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PMID:Ischemic hepatitis in cirrhosis. Rare but lethal. 840 9


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