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

Meningococcal meningitis as well as meningococcal sepsis must be regarded as complications of an otherwise mild meningococcal infection of the nasopharynx. Only individuals without antibodies against a given meningococcal type will contract the above-mentioned diseases. Causal prophylactic measures have proved to be ineffective because of the great number of "carriers" of meningococci. Immunprophylaxis with specific polysaccharides is effective and presently available for use against types A and C but not against type B. Chemoprophylaxis is most effective when administered to those living in close quarters. Sulfonamides are the prophylaxis of choice agianst meningococci sensitive to sulfonamides. With the appearance of sulfonamide-resistant meningococci, the sulfonamide must be replaced by rifamycin or minocyclin. Though treatment with penicillin gives protection against infection, it does not eradicate the carrier state.
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PMID:[Prevention of meningococcal meningitis]. 40 42

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

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

A large epidemic (February-August 1988) of group A sulphonamide resistant, clone III-1 meningococcal meningitis in Khartoum, Sudan is described. A total of 10,099 cases were admitted to treatment centers with 8,397 cases during March and April, corresponding to an annual incidence of 1,679/100,000 inhabitants during this period. The age profile showed a high morbidity in adults (31% of the cases greater than or equal to 20 years). The male dominance was marked especially in the adult cases with a proportion of 3.2:1. The epidemic started during the hot and dry season and declined when the clouds came, humidity rose, temperature fell and a mass vaccination campaign had been implemented together with other epidemic precautions. Vaccination with a combined group A/C polysaccharide vaccine had been given 4 weeks-1 year before hospitalization to 11% of the children, 80% of whom were greater than 18 months of age. The estimated case fatality rate was 6.3%. Since 47% of the cases came from periurban and rural areas, the actual mortality during the epidemic might have been higher when considering those who may have died before reaching any of the treatment centres. Fatal cases had a short history of acute illness and a septic condition. Septicaemia was rare and seen in only 3.7% of the cases, the rest had acute purulent meningitis. Hearing loss/impairment and hemiplegia was diagnosed in 2-3% of the cases. The epidemiology, based on detailed typing/subtyping and restriction enzyme patterns of meningococcal strains, was apparently associated with the Mecca outbreak in August 1987.
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PMID:Features of a large epidemic of group A meningococcal meningitis in Khartoum, Sudan in 1988. 235 40

A series of patients with meningococcal infections have been studied and divided in two groups: Group I patients with meningococcal sepsis and group II, those with meningococcal meningitis. Patients in group I presented with more severe encephalopathy, shock, DIC and acute systemic complications. Both groups showed a marked hypoaminoacidemia compared with normal controls (other than for the sulfur containing amino acids and phenylalanine). The concentration of aromatic and basic amino acids, the phenylalanine/tyrosine ratio, the transaminase levels and the negative nitrogen balance were higher in group I patients. The ratio of branched chain to aromatic amino acids was lower in group I. All these differences were statistically significant. The close association between the metabolic derangements and clinical manifestations may help in the understanding of several physiopathological aspects of meningococcal infections.
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PMID:Significance of the changes in plasma amino-acid levels in meningococcal infection. 365 98

Eighteen patients less than 15 years of age (range, 1.5 to 15 years) were followed prospectively after undergoing splenectomy for blunt trauma. Follow-up time ranged from 1 to 12 years with a mean of 5.8 years. During the follow-up period significant septic episodes developed in two of the 18 (11.0%) patients. During the same period 16 patients less than 15 years of age (range 2 to 15 years) who underwent splenorrhaphy were followed. In none of the patients in the splenorrhaphy group has sepsis developed to date (P = .11). Follow-up studies in both groups included a CBC, peripheral smear, platelets counts, history of infections, and radionuclide scans in the patients undergoing splenorrhaphy. The two patients with significant sepsis were an 18-month-old male with pneumococcal septicemia and a 13-year-old with meningococcal meningitis. Both patients survived these episodes. Although the numbers are small, this prospective study reemphasizes the increased risk of sepsis in the asplenic pediatric patient and the need for close surveillance, parental education, appropriate immunizations, and vigorous treatment of infections. The methods used in this prospective study of patients from one institution could be expanded to a multi-institutional study to obtain prospective data concerning the natural history of pediatric patients undergoing splenectomy because of trauma.
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PMID:Postsplenectomy sepsis in pediatric patients following splenectomy for trauma: a proposal for a multi-institutional study. 379 73

N. meningitidis continues to be a worldwide cause of human disease, usually in otherwise healthy individuals. The natural habitat and reservoir for meningococci are the mucosal surfaces of the human nasopharynx and to a lesser extent, the urogenital tract and anal canal. In most instances meningococcal colonization of mucosal surfaces is asymptomatic but may produce local infection. In those individuals who lack serum bactericidal activity against the meningococcus, colonization of mucosal surfaces and bloodstream invasion by N. meningitidis can lead to devastating meningitis and septicemia. Recent studies on the ultrastructure of the meningococcus and on the mechanisms of pathogenesis have given us new insight into meningococcal infections and suggest ways for improved immunoprophylaxis. Currently, penicillin is the drug of choice for the treatment of meningococcal meningitis and septicemia. However, the report of meningococci with antibiotic resistant plasmids is alarming and in the future may alter traditional treatment regimens.
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PMID:Neisseria meningitidis. 391 87

Neisseria meningitidis is an important cause of fulminant septicemia and meningitis in children. Only limited reports of mild disease associated with this organism exist. In this study, we describe eight children, ages 2.5-19 months, with mild meningococcal disease and characterize the meningococcal isolates from some of these patients. Children with mild meningococcal disease presented with a mean fever of 40.1 degrees C, but without purpura or petechiae. Five were diagnosed as having otitis media and were not thought to be seriously ill when initially observed. Six of the eight children had complete resolution of their clinical symptoms as outpatients. One had apparent meningococcal meningitis that sterilized without antibiotic therapy, and one had persistent low grade bacteremia that cleared within 48 hours after institution of parenteral antibiotics. Characterization of the meningococcal isolates from three of the patients revealed that the organisms were encapsulated, piliated, and contained similar outer membrane proteins. This report confirms that blood stream invasion by N. meningitidis organisms may result in clinically mild disease.
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PMID:Clinical features of mild systemic meningococcal disease with characterization of bacterial isolates. 393 50

A high annual incidence of meningococcal meningitis and septicemia occurred in Spain from 1976 through 1980 with a peak of 19 cases per 100,000 population in 1979. Approximately 80% were caused by group B Neisseria meningitidis. Studies were undertaken to determine the distribution of groups, outer membrane protein serotypes and polyacrylamide gel electrophoresis (PAGE) types among 338 disease-associated group B isolates from six regions of Spain. The related serotypes 1, 8, and 15 accounted for 38% (129 of 338) of the isolates. Serotype 2, the major disease type in the United States, was responsible for 14% (48 of 338) of the disease in Spain and was prevalent in only one region. Forty-three percent (146 of 338) were nonserotypable. The predominant PAGE type among the nonserotypable strains was PAGE type IV (79%). These studies demonstrate the necessity of surveillance for selection of suitable serotypes to be included in protective group B meningococcal vaccines.
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PMID:Serotypes and polyacrylamide gel electrophoresis types among disease-associated isolates of group B Neisseria meningitidis in Spain, 1976-1979. 641 31

In the period 1973 through 1978, the New York City Department of Health serogrouped 648 isolates of Neisseria meningitidis and investigated 259 cases if meningococcal meningitis and meningococcemia. Although meningitis and septicemia were mainly due to groups B and C, groups Y and W-135 caused nearly one third of the cases. There was no difference in mortalities when disease caused by the classic groups A, B, and C was compared with disease caused by the new serogroups X, Y, Z, W-135, and Z'. Most isolates from the respiratory tract were from the new serogroups, especially Z and Z' (some from patients with pneumonia), as were most of those from the genitourinary tract, anal canal, and miscellaneous sites. Group X was infrequently seen. Although most of the isolations of these groups of N meningitidis are apparently from asymptomatic carriers, Y and W-135 do cause a substantial number of acute symptomatic infections, in particular, septicemia.
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PMID:Meningococcal disease in New York City, 1973 to 1978. Recognition of groups y and W-135 as frequent pathogens. 677 3


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