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

Nowadays, in severe infections during the neonatal period new bacteria--group B streptococci--have to be taken into account, since in some clinics they already predominate over gramnegative rods. Septicemia and meningitis may be caused by group B streptococci. The septicemia which especially threatents prematures starts with apnoeic spells in the very first hours after birth and may be easily misdiagnosed as an idiopathic respiratory distress syndrome. The mortality is very high (about 60%). Meningitis starts later, normally during the 3rd to 4th week. Seizures are typical at the onset. Group B streptococci may be identified in the CSF by counterimmunoelectrophoresis within one hour. The prognosis is more favourable in meningitis than in septicemia (mortality about 20%). Survivors have little neurological sequelae. Penicillin G or ampicillin combination with an aminoglycoside is recommended as chemotherapy. Exchange transfusion should be considered early. Group B streptococci causing the septic form may be transfered during labour since up to 25% of pregnant women are colonized. Nosocomial transmission of group B streptococci may be the reason for meningitis. Prophylactic penicillin does not seem to help in preventing the disease, but it is possible, that meningitis of the newborn may be prevented by immunizing the mother during pregnancy.
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PMID:[Group B streptococcus infections during the neonatal period (author's transl)]. 35 54

The longterm prognosis of neonatal septicemia during the first four weeks of life has been estimated. Of 90 infants with the diagnosis of neonatal septicemia during a five-year period, 1969--1973, 65 infants survived the initial treatment. Another two infants died with complications of their main disease, intestinal atresia, at the age of two months. Thus the total mortality in neonatal septicemia in this series was 30%. The remaining 63 children have been investigated between ages of 2 1/2 and 6 1/2 years. Of these 63 children we have found 14 children (22% of the surviving) with handicaps where the septicemia can be regarded as a possible cause of the handicap. Of these 14 children only six had an "uncomplicated" septicemia while four of them had meningitis and four had osteomyelitis. Furthermore, of the 14 handicapped children nine were delivered preterm (28--36 weeks) and all of them had one or more additional neonatal diagnoses than septicemia. The prognosis, both immediate and longterm, of neonatal septicemia in the present series compares favourably to most international studies. The importance of early detection together with an aggresive treatment of the septicemia is stressed and is considered as the main reason for the good prognosis.
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PMID:Longterm follow-up of neonatal septicemia. 36 3

The usefulness of CRP in early detection of neonatal septicemia/meningitis and urinary tract infection was studied in a neonatal unit using a semiquantitative latex-agglutination as a rapid screening method, and electroimmuno assay as reference method for CRP determination. In 94% of non-infected infants CRP was less than or equal to 15 mg/l and 82% had CRP less than 10 mg/l up to 3 days of age. After 3 days of age 96% had CRP less than 10 mg/l. The initial CRP level was increased in 16 out of 18 patients (89%) with bacterial septicemia. Low CRP was seen in one patient with total agranulocytosis and septicemia from Streptococcus type B and in one patient with Staphylococcus albus sepsis. A rise in CRP was also seen in very pre-term infants with septicemia. Increased initial CRP was uncommon in neonatal urinary tract infection (2 of 9), but a rise was seen in 3 additional patients. A comparison between CRP, total neutrophil blood cell count and band neutrophil count as diagnostic parameters was in favour of CRP at this early stage of infection. CRP is of definite value as an aid in early diagnosis of neonatal septicemia and bacterial meningitis.
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PMID:C-reactive protein (CRP) in early diagnosis of neonatal septicemia. 39 15

Salmonella typhimurium was isolated from a fatal epidemic among premature and newborn infants in the Children's Hospital of Hacettepe University. The epidemic showed gastroenteritis, sepsis and meningitis. Salmonella typhimurium were isolated from 17 of 65 infants. No salmonellae were isolated from the personnel of the unit and from the personnel of the related kitchen. The mothers could not be examined. Examinations are being continued with the collaboration of the said unit and a more detailed report is being prepared.
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PMID:[A Salmonella typhimurium epidemic in premature and newborn infants (author's transl)]. 39 93

We performed field trials in the course of an epidemic in Finland to learn whether Group A memingococcal capsular polysaccharide vaccine protects infants and young children from meningitis. The first trial involved 130,178 children between the ages of three months and five years; 49,295 children received the vaccine, 48,977 received a control Haemophilus influenzae Type b polysaccharide vaccine, and 31.906 remained unvaccinated. No cases of meningitis or sepsis caused by Group A meningococci were seen in the first year of observation among the children vaccinated with meningococcal vaccine whereas six occurred among those vaccinated with the H. influenzae vaccine and 13 among those not vaccinated. In the second trial 21,007 children of the same ages received the meningococcal vaccine. No cases caused by Group A occurred among those vaccinated, although five to seven would have been expected within the year. Meningococcal Group A vaccine appears efficacious in young infants and children.
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PMID:Clinical efficacy of meningococcus group A capsular polysaccharide vaccine in children three months to five years of age. 40 82

We report three mildly ill infants who had meningococcal bacteremia and in whom meningitis or fulminant septicemia never developed. The infants were observed during a three-month period. Two of these infants had pneumonia, as evidenced by infiltrates on chest roentgenogram. The serogroups of the organisms isolated were B, Y, and 135. In none of the infants could specific bactericidal antibody be demonstrated in acute or convalescent serum.
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PMID:Meningococcal bacteremia: clinical and serologic studies of infants with mild illness. 40 80

Eighty four cases of meningococcal infections are reviewed. Fifty seven cases presented themselfs as meningococcal meningitis, twelve cases as sepsis with moderate hypotension and 15 cases were sepsis with septic shock. A brief course of the disease, shock, echymosis, absence of meningeal signs, leucopenia and intravascular coagulation were findings more frequent in the group of patients with hiperacute sepsis, whereas other signs as fever, headaches, vomiting and petechiae were present with equal frequency in the three groups. N. meningitis was isolated in 73% of the cases. Shock (18.85%) and intravascular coagulation (12%) were the complications more frequently found, followed by convulsions (4.81%), arthritis (4.81%), skin necrosis (4.81%), subdural efusion (3.57%), cerebral palsy (3.40%), thrombophlebitis (1.20%), recurrence (1.20%), inapropiate antidiuretic hormone secretion (1.20%) and subaracnoideal hemorrage (1.20%). The overall mortality was 10.70% and 60% of the patients which initially presented with shock and intravascular coagulation died. Autopsy findings included wide spred hemorragic lesions and intravascular thrombi in skin, mucous membranes and viscera. Adrenal hemorrhage was present in five of the six cases studied.
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PMID:[Incidence, clinical, forms and complications of meningococcal infections (author's transl)]. 41 52

Six children, out of twelve in a neonatal unit suffered from group D salmonellosis. Two patients presented in addition to intestinal manifestations massive extraintestinal symptoms, both with septicemia and meningitis. One patient died on the fourth day from massive disseminated intravascular coagulation and pyocephalus. The other patient had a complete recovery after an antibiotic therapy with chloramphenicol and ampicillin. As the source of infection the mother of case 1 was identified. In her stools salmonella group D were cultured. Cultures of the ward-personals, stool and the food were negative. It should be mentioned that only children fed with artificial food suffered from salmonellosis; whereas children on breastmilk had an unremarkable clinical course and consistantly negative stoolcultures.
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PMID:[Salmonella-meningitis in the newborn (author's transl)]. 46 Feb 61

The maternal deaths occurring in the Kilimanjaro Christian Medical Center (KCMC), which serves as a supraregional reference hospital for the 5 regions of Northern and Central Tanzania, are reviewed for the 1971-1977 period and avoidable factors are discussed. All deaths occurring within the hospital during pregnancy or the first 6 weeks of the puerperium were included in this survey. Postmortem examination was performed in 35% of the cases. In the remaining cases the diagnosis was made on clinical grounds. During the period under review, there were 10 deaths among 83 cases, a mortality of 12%. The major cause of rupture was obstructed labor associated with a contracted pelvis or abnormal lie. 25% of the patients had had a previous cesarean section scar give way. 2 other deaths were attributed to anesthetic accidents and 1 was probably due to pulmonary embolism. The primary cause of death in the 7 remaining cases was hemorrhage (4) and sepsis (3). If deaths from ruptured uterus are to be avoided, early diagnosis is essential. 1044 cases of moderate and severe EPH gestosis (preeclampsia) were treated in KCMC during the period under review together with 54 cases of eclampsia. There were 5 deaths among the patients with eclampsia, a mortality of 9%. In addition to the 11 sepsis deaths there were 3 others included among the cases of ruptured uterus. There were 4 cases of septic abortion and 3 of those admitted to criminal interference. Preexisting anemia was a complicating factor in 5 cases, all of whom died within 15 minutes of arrival. There were 4 deaths among 251 cases of ruptured ectopic pregnancy. There were 10 deaths associated with cesarean section among 1271 sections peformed during the period under review. Deaths from associated diseases included the following: enterocolitis (12 deaths); renal and hypertensive disease (4 deaths); cardiac disease (2 deaths); anemia (2 deaths); malaria (2 deaths); tuberculous meningitis (2 deaths); and miscellaneous associated conditions (11 deaths).
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PMID:Maternal deaths in the Kilimanjaro region of Tanzania. 47 24

A 73-year-old patient with a cerebral abscess of tuberculous etiology localized in the left parietooccipital region is presented. Clinically it had behaved like an expansive process. The inside of the abscess contained a purulent exudate with polynuclear cells and necrotic material. The wall of the abscess was formed by a predominantly histiocytic internal layer and an external one composed by histiocytes with the morphology of epithelioid cells. No tuberculous granulomas were found. The histiocytes contained a large number of acid-alcohol resistant bacilli. In the exudate Mycobacterium tuberculosis hominis was bacteriologically isolated. After the surgical operation the patient developed an acute tuberculous sepsis with tuberculous exudative meningitis and miliary dissemination in various organs. As regards the pathogenesis of the tuberculous cerebral abscess the authors consider the possible influence of a deficitary immune state of the patient and the aggressiveness of the infective organism.
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PMID:[Tuberculous cerebral abscess. Morphopathologic study (author's transl)]. 49 87


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