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

Three patients with a history of anterior spinal surgery treated with a polymethylmethacrylate construct had extrusion of their constructs. In two instances, there were life-threatening esophageal fistulas, mediastinitis, and sepsis 3 months to 10 years after the original surgery. Surgical treatment required removal of the construct, treatment of the esophageal injury, and use of new spinal stabilization. Based on their experience and a review of the literature, the authors strongly recommend against the use of polymethylmethacrylate alone in anterior procedures involving the cervical spine except to treat malignancies in patients with a short life expectancy.
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PMID:Short-term and long-term failures of anterior polymethylmethacrylate construct with esophageal perforation. 851 7

It is important that surgical treatment of infective endocarditis involves complete debridement of the affected tissue. In case of abscess formation in the mitral anulus and/or aortic root, disruption of the anulus occurs because of radical resection of the abscess. David et al. reported a new technique for mitral and aortic anulus reconstruction. The novel part of the technique was the endocardial repair, i.e., suturing of a pericardial patch to the endocardium of the left ventricle. We were surprised to learn that the left ventricular endocardium and muscle are capable of tolerating the stress induced by the prosthetic ring, especially in the mitral position. Since 1992, we treated eight cases of anulus disruption using this technique ; 5 cases involved the mitral anulus, 1 involved the aortic, and 2 involved both. We used a slightly different technique involving suturing of a patch not only to the left ventricular endocardium but also to left atrial wall for reinforcement. Two patients died in the perioperative period. One had a brain abscess ; the other had methicillin-resistant Staphylococcus aureus sepsis and mediastinitis. There was 1 late (sudden, unknown) death 3 years after the operation. No perivalvular leakage, dehiscence of the patch, hemolysis, prosthetic valve endocarditis, or thromboembolism have been observed in the other 5 patients.
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PMID:[Valve replacement concomitant with anulus reconstruction]. 874 30

From 1978 through 1995, surgical treatment for active infective endocarditis (native valve) was performed in 17 patients. The indication for operation at the active phase was progressive heart failure in 5 (A-group) and uncontrolled infection in 12 (B-group). Operative findings showed vegetations in all cases, perforations of the valve in 6, rupture of tendon in 2, and annular abscesses in 2. One patient in B-group died 14 days after the operation with postoperative mediastinitis and sepsis. There was no perioperative complications in A-group. In B-group before operations 8 patients (66.7%) has an embolic event before operations. The anatomic sites of embolization were the central nervous system (3 patients), viscera (2 patient) and peripheral arteries (3 patients). And after operation there were 2 mycotic aneurysms of the hepatic artery and the popliteal artery, and 1 pyogenic spondylitis. We conclude that the risk of embolization is high in patients undergoing surgery at active phase of infective endocarditis because of uncontrolled infection ; thus, such patients should be carefully monitored for emboli and mycotic aneurysms.
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PMID:[Surgical treatment for active infective endocarditis : septic embolization and mycotic aneurysms]. 874 37

The aspects of acute purulent mediastinitis (APM) have been reported on the basis of the analysis of 14 cases treated in the last 5 years. The most frequent causes of APM were the complications after surgery on esophagus ad trachea (10 cases). The other group included patients operated on by sternotomy. Three patients survived. In both of them diagnosis was established within 12 hours from the beginning of APM and early re-thoracotomy was performed. The rest of the patients died because of sepsis and multiply organ failure (MOF). The conclusion is that only early diagnosis as well as aggressive surgical treatment give a chance to save life in such a dangerous severe complication.
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PMID:[Purulent mediastinitis]. 892 79

Adenopathies in general and cervicofacial adenopathies in particular are a pathology that can affect both medical and surgical disciplines. They may be found in both acute and chronic disorders, in children and in adults, and in local or systemic forms with benign or malignant pathogenesis. It is clear that the differential diagnosis and consequently the therapeutic approach may be complicated at times by the variety of pathological processes. Interest in the case reported her is, in our opinion, justified by the rare finding in the age of antibiotics of such striking symptoms. The severity of local symptoms and the general conditions of the patient resulted in the need for surgery under anesthesia in order to enable the extensive collection of purulent matter to be drained. The postoperative course showed a marked and progressive improvement of the patient's general and local conditions, even a few hours after surgery. Given that several factors contribute to determining the evolution of septic conditions (patient's general and in particular immunological status) and given that, owing to the aspecific nature of symptoms, the diagnosis and relative specific therapy may be delayed, it can be seen that the clinical picture may evolve and be complicated by massive general manifestations, sufficient in extreme cases to endanger the patient's life, in the form of acute and sudden respiratory disorders and or more gradually with generalised septic conditions (encephalitis, mediastinitis and generalised sepsis). The objective to be attained is therefore a careful diagnosis and the immediate implementation of medical procedures in order to remove the cause that has triggered off the pathology.
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PMID:[Adenophlegmons of the neck area. A case report and review of the literature]. 902 92

We experienced a curative case, who was a fifty nine-year old man suffered from multiple organ dysfunction syndrome (MODS) and disseminated intravascular coagulation (DIC) due to Methicillin-resistant Staphylococcus aureus (MRSA) caused-mediastinitis following cardiac surgery against atrial septal defect (ASD) and tricuspid regurgitation. We successfully treated him with mediastinal irrigations by a large quantities of physiological saline containing 1% Povidone iodine (PI) and MRSA sensitive antibiotics as well as artificial supports such as plasma pheresis and hemodialysis against failure organs. It may be due to the prompt treatment with mediastinal irrigation and well timed dosage of sensitive antibiotics against the origin of sepsis that such a serious patient like this case could be recovered from MODS and DIC. In addition, it may be very effective to irrigate with 1% PI against MRSA-caused-mediastinitis.
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PMID:[A curative report of multiple organ dysfunction syndrome and disseminated intravascular coagulation due to methicillin-resistant Staphylococcus aureus caused mediastinitis after cardiac surgery]. 902 73

Oesophageal perforations are associated with a high mortality and morbidity. Intrathoracic perforations especially are associated with mediastinitis and sepsis. The repair of these perforations may be difficult, particularly when there has been a delay to diagnosis. We report our use of a method to repair or buttress the suture line after repair with a vascularized intercostal muscle flap, having used it successfully in two patients with intrathoracic oesophageal perforations.
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PMID:Intercostal pedicle flap for thoracic oesophageal perforations. 906 57

The function of the liver is assessed in patients with maxillofacial phlegmons suffering from endogenic intoxication of different severity. The most marked changes of the enzymatic activity of the liver were observed in patients with progressive phlegmons and complications thereof (mediastinitis or sepsis) involving endotoxicosis of the second or third degree. The authors come to a conclusion on the functional hepatic failure in patients with phlegmons of the face and neck, which fact should be borne in mind when planning combined therapy of this patient population.
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PMID:[The effect of endogenous intoxication on liver function in patients with phlegmons of the face and neck]. 916 81

Mediastinitis occasionally develops as a complication of cervical or odontogenic infections resulting in neck sepsis, which spreads to the mediastinum via the cervical facial planes. Nowadays, this rare complication of pyogenic orofacial infections has an high-unchanged mortality rate. Delayed diagnosis and inadequate mediastinal drainage are the primary causes of this high mortality rate. Aggressive empirical antibiotic combinations should be directed towards this polymicrobial process. Antibiotic therapy alone is inadequate and the mainstay of treatment is aggressive surgical drainage through cervical and thoracic approaches. The assessment and management of the airway is critical; most authors recommend early tracheostomy in a controlled fashion in all cases of serious neck infections with or without thoracic involvement. However, we consider tracheostomy not always necessary and we only perform it in patients with severe dyspnea from upper airway obstruction.
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PMID:Mediastinitis as a rare complication of an odontogenic infection. Report of a case. 948 42

A case of descending necrotizing mediastinitis that was treated by mediastinoscopic drainage is reported. The patient was a 56-year-old diabetic woman. A hypopharyngeal abscess extended to the mediastinum through the neck. No septic condition was noted. Chest CT showed that the abscess reached 4 cm below the tracheal bifurcation. Pus was drained under direct observation by mediastinoscopy, and a drain was placed in an appropriate position. After operation, lavage was performed through the drain, and cure was achieved on the 42nd postoperative day. This technique should be considered as surgical treatment for descending necrotizing mediastinitis in the absence of serious complication such as sepsis, because it has a more reliable drainage effect than the conventional transcervical method, and because it is less invasive than thoracotomy.
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PMID:[Mediastinoscopic drainage for descending necrotizing mediastinitis]. 955 62


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