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

An increased morbidity by Streptococcus agalactiae (group B streptococci) during the perinatal period was to be found in some countries since 1961. Six cases of group B streptococcal meningitis were confirmed by the Central Streptococcus Laboratory of the GDR from July to December 1975. Therefore it is necessary to look for group B streptococcal infection in certain cases of diseases of the newborn. In a short review of literature the clinical signs (acute onset with respiratory distress, sepsis or late onset with meningitis), prevalence, source of infection and therapy (ampicillin or a combination of penicillin G and gentamicin) were summarized. The diagnosis is confirmed by isolation of group B streptococci.
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PMID:[Infections in newborn infants caused to B-streptococci]. 79 Aug 43

Twenty-eight strains of E. coli isolated from infants were compared with respect to opsonic requirements, sensitivity to serum, and ability to activate serum chemotactic factors. Six of the strains were isolated from stools of healthy newborn infants; 22 were isolated from the cerebrospinal fluid or blood of infants with meningitis and/or septicemia. Eighteen of the strains had K1 polysaccharide antigen. Fourteen of the strains (seven with K1 antigen) activated complement via the alternative pathway and all of these strains were well opsonized in 4% pooled human serum. A higher concentration of serum was necessary to opsonize 12 of the 14 strains that did not activate the alternative pathway. A wide variation was also found in opsonic requirements of E. coli strains isolated from healthy and sick infants. There was no relationship of the K1 antigen to opsonic requirements, to capacity to activate complement via the alternative pathway, to generation of chemotactic factors, or to sensitivity to serum cidal activity. Therefore, the association of E. coli with K1 antigen and neonatal meningitis did not appear to be related to these bacteria-serum interactions.
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PMID:Interaction of E. coli strains with human serum: lack of relationship to K1 antigen. 79 9

The Esch. coli harboured in the gut constitute a reservoir of potential pathogens in the infant and child. The conditions required for these intestinal inhabitants to cause infection are not well understood. The presence of virulence factors such as capsular antigens, especially K1, may be of significance for the ability of Esch. coli to cause neonatal meningitis. The capacity of certain Esch. coli to attach to epithelial cells of mucous membranes may be important for their infective powers in the urinary as well as the intestinal tract. Furthermore, the ability of certain Esch. coli to produce enterotoxins similar to that of V. cholerae is of importance for their capacity to provoke diarrhoea. The importance of the immune defence mechanisms for prevention of these Esch. coli infections is suggested, especially in the form of local immunity provided by secretory IgA antibodies. Such antibodies directed against Esch. coli O and K antigens as well as enterotoxins are present in large amounts in human milk and may be of considerable importance for protection against Esch. coli in the breast-fed baby. Breast feeding may be of special significance until the baby has built up its own local immune defence preventing the micro-organisms from attaching to and invading the intestinal mucous membranes. SIgA antibodies in urine may have a similar protective effect against urinary tract infections. The variable pictures of Esch. coli infections in childhood are striking, ranging from severe sepsis/meningitis or diarrhoea to "asymptomatic" bacteriuria. This variability is obviously closely connected with the presence of various virulence factors and the function of different components of the immune defence.
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PMID:Esch. coli infections in childhood. Significance of bacterial virulence and immune defence. 79 81

Information from 50 infants with neonatal septicemia from the Louisville General Hospital during an eight-year period (1964-1972) is presented. Twenty-five infants had gram-positive and the other 25 had gram-negative organisms. E. coli (13 cases), staphylococcus (10 cases), and hemolytic Streptococcus non-Group A (7 cases) were the mustcommon causative microorganisms. Only one of the 25 infants with gram-positive sepsis died; three with gram-negative sepsis died. Listeria monocytogenes was demonstrated in three infants; all had meningitis with no mortality. Early diagnosis, prompt intensive antibacterial therapy, and a high index of suspicion are most helpful for reducing the morbidity and mortality.
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PMID:Neonatal sepsis. A survey of eight year's experience at the Louisville General Hospital. 80 22

The authors report two newborn infants, one with sepsis and the other one with meningitis, discussing clinical and epidemiological aspects of this infection.
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PMID:[Listeria monocytogenes infection]. 81 20

1. Where a purulent meningitis develops in association with a cyclic infectious disease (e.g. meningococcal meningitis), the prognosis is to be designated good, provided that it is diagnosed early and that no Waterhouse-Friderichsen syndrome is present and that adequate treatment is carried out. 2. In transmitted meningitis after purulent processes in the head region (sinusitis, otitis media), in addition to early diagnosis and antibiotic therapy the suppurating focus must also be cleared out in time. 3. The worst prognosis is for a purulent meningitis associated with sepsis, because here there must not only be early recognition and treatment of the meningitis, but also the recognition and treatment of the septic focus.
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PMID:[Influence of pathogenesis of purulent meningitis on the prognosis (author's transl)]. 82 5

Pneumococcal pneumonia in two or more lobes in frail, elderly patients; staphylococcal and Gram-negative rod pneumonia in patients of any age; lung abscesses; septicemia; endocarditis; peritonitis; and meningitis are life-threatening infections. To save patients with these infections, the physician should know the causative organism and educate himself by cultures; estimate the whole body bacterial burden and decrease bacterial numbers by incision and drainage where large collections of pus are accessible; choose antibiotics with care and use two antibiotics if serious prognostic signs are present initially, if there is a change for the worse, or if the laboratory report indicates that multiple organisms are present; check the serum bactericidal level and repeat this test if the route of antibiotic administration is changed; watch for and treat underlying disease; and always monitor for septic shock. Aged patients need special care, as they often have severe underlying disease. The bacterial burden is often high before infection is recognized in elderly patients, and age itself interferes with host defenses.
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PMID:Life-threatening infections: how to choose the right antibiotics. 84 91

Two newborn siblings, one with meningitis and one with sepsis due to Listeria monocytogenes, were born to a healthy, 33-year-old woman. She had had a spontaneous abortion prior to the birth of these infants. In spite of negative cultures, persistence of this bacterium in the mother's genital tract and perinatal acquisition of infection is suspected.
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PMID:Infection in newborn siblings. 84 61

The development of antibody in response to invasive infection with type III strains of group B Streptococcus was studied in sera from 31 infants and 4 adults by means of a quantitative radioactive antigen-binding assay. Low concentrations of antibody were consistently found in the acute sera of patients who developed clinical illness. Although adults with puerperal sepsis and infants with bone or joint infection uniformly demonstrated significant rises in serum antibody concentration after recovery, much lower levels of antibody were detected in convalescent sera from infants recovering from meningitis or sepsis. The median antibody concentration in sera from 43 parturients with type III strains of group B Streptococcus isolated from vaginal cultures whose neonates failed to develop symptomatic disease was significantly greater than that in sera from 29 mothers of infants with invasive, type III, group B streptococcal infection. Study of paired maternal and cord sera demonstrated a significant correlation between the antibody concentration in a mother's serum and that in her neonate.
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PMID:Quantitative determination of antibody to capsular polysaccharide in infection with type III strains of group B Streptococcus. 85 69

We have presented recommendations for diagnosis and management of otitis media in children based on a comprehensive review of the pertinent medical literature. For an entity that is so common, there still remain amazingly large numbers of areas of controversy. We have also attempted to stress the importance of appropriate therapy and adequate followup as being very important in the management of otitis media. Newer concepts, particularly the use of the impedance bridge tympanogram, have been mentioned. With all the above background information in mind and with considerations for what is practical for the patient and the medical community, we would recommend the following as the acceptable minimal care for patients with otitis media. When the diagnosis of the acute otitis media is made on the basis of physical findings of myringitis, and/or middle ear fluid, and/or rupture of the tympanic membrane, the following treatment course is advisable: Neonates Culture of middle ear fluid if possible. Ampicillin 200 mg/kg/day intramuscularly. Gentamicin 3/5mg/kg/day intramuscularly. Hospitalize and treat until well and for minimum of seven days. Observe closely for meningitis and other infections and drug toxicity. These should be handled only by physicians experienced in dealing with patients in this age range. Appropriate work-up for septicemia should precede treatment. Switch to specific antibiotic when cultures and sensitivity available. Children. From 2 months to 6 years of age: Ampicillin 50mg/kg/day. Decongestant (if desired). Administer for ten days. Every patient with otorrhea, severe otitis and those not clinically well should be seen for followup ten to 14 days later. They should have a minimum of otologic evaluation including drum mobility. In persistent cases, audiometry and otologic referral are necessary. If patient is allergic to penicillin, erythromycin at 20mg/lb/day may be used. Trimethoprim sulfa may hold promise in the future. Tetracycline is never indicated in this age range because of side effects and high relapse rate secondary to resistant organisms. Patients above 6 years of age: Penicillin pheyoxymethyl 250 mg every six hours for ten days. Decongestant (if desired). Followup and penicillin allergy as above.
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PMID:Otitis media: a review. 87 Oct 68


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