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

Two patients had streptococcal myositis. Both patients developed extensive muscle necrosis and overwhelming sepsis after trivial skin trauma. Death occurred within 48 hours of hospital admission despite aggressive surgical and medical treatment. Review of the literature is included to highlight the fulminant nature of this unusual infection and to contrast streptococcal myositis with other soft-tissue streptococcal infections.
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PMID:Streptococcal myositis. 389 Jul 87

Two cases of Yersinia enterocolitica septicemia occurred in a breeding group of 22 adult patas monkeys (Erythrocebus patas). Affected animals had acute clinical signs of depression, weakness, dehydration, hypothermia, hepatomegaly and pronounced leukopenia. Both animals died a few hours after treatment was initiated. Gross necropsy findings included jaundice, fluid in body cavities, hepatomegaly, splenomegaly, multiple white foci within the liver and spleen, generalized lymph node enlargement and numerous mucosal ulcerations in the colon. Primary histopathological lesions were multifocal hepatic necrosis, splenic necrosis, chronic ulcerative enteritis and diaphragmatic myositis with necrosis and edema. Yersinia enterocolitica was cultured from the liver, spleen, lung, jejunum and rectum. Wild rodents, particularly mice, may have been a source of infection for these animals, as the monkeys were housed in a rural, indoor-outdoor facility. A preliminary culture survey showed that some clinically normal patas monkeys harbored the organism in their intestinal tracts.
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PMID:Naturally occurring Yersinia enterocolitica septicemia in patas monkeys (Erythrocebus patas). 405 42

Rectal abscess may result in necrotizing soft-tissue infection including fasciitis, myositis, and extraperitoneal dissection of pus without muscle necrosis. The presentation and therapy of ten patients treated over the past six years are reviewed. Early recognition of rapidly spreading infection was imperative. The mortality rate of 40 per cent correlated with the degree of sepsis present at admission. The high mortality attendant with the complications of rectal abscess emphasizes the need for aggressive therapy, including frequent examinations under anesthesia, wide debridement, systemic triple antibiotic therapy, diverting colostomy, aggressive wound care, and hyperalimentation.
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PMID:Necrotizing soft-tissue infection from rectal abscess. 640 68

A 13-year-old girl incurred gas gangrene after intramuscular injection of adrenaline to the buttock. Clinical evidence of very severe pain at the site of injection with septicemia and collapse within 24 to 48 hours should arouse the suspicion of clostridial myositis rather than pyogenic infection. Early diagnosis and treatment by adequate excision of necrotic muscle (with a wide margin of normal-appearing muscle) can prevent loss of life or limb in these patients.
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PMID:Gas gangrene after intramuscular injection of adrenaline. 683 5

We describe two patients with acute recurrent focal myositis affecting discrete muscle groups. Sepsis was initially suspected in both cases and excluded only after surgical intervention. Spontaneous remissions occurred and extensive investigations have not demonstrated a precipitating cause.
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PMID:Idiopathic recurrent non-suppurative focal myositis: a report of two cases. 806 9

Lancefield group A streptococci (GAS) account for 3-17% cases of septic arthritis, but other beta haemolytic streptococci (BHS) (groups B, C, and G) are being increasingly implicated. Epidemiological evidence suggests that the increase of BHS sepsis in adults is a true increase and not simply a reflection of better reporting. While underlying predisposing disease and old age are common concomitants of BHS sepsis, some subjects with devastating disease have been young and healthy. This is particularly the case for highly virulent M1 serotypes of GAS, where a toxic shock-like syndrome has led to a number of deaths in young adults in the United Kingdom and elsewhere. Musculoskeletal features, such as myalgias, painful swollen limbs, myositis, and fasciitis, are important features of this condition, so that rheumatologists may be involved in management. Group C and G musculoskeletal sepsis remains uncommon, with a high prevalence of underlying predisposing disease, or pre-existing arthritis in the septic joint. Group B BHS septic disease appears to be increasing in incidence. Musculoskeletal sepsis with these organisms usually takes place in subjects with other diseases, but healthy subjects have not been spared. Multiple septic foci and a rapidly destructive arthritis are not uncommon, and a recently described extra-articular feature is potentially blinding metastatic endophthalmitis. Clinicians need to be aware of an apparently increasing incidence of BHS musculoskeletal sepsis in adults so that early identification can lead to aggressive management in these potentially fatal infections.
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PMID:Beta haemolytic streptococci and musculoskeletal sepsis in adults. 832 4

A 25-year-old patient with lupus erythematosus was admitted with myositis and erythema of the skin under chloroquine therapy. After improvement of clinical symptoms with cyclophosphamide and prednisolone he was again progredient with myositis. The changing of therapy to methotrexate showed a hepatotoxic side effect with elevated liver enzymes. Under subsequent therapy with azathioprine and prednisolone he developed leukopenia and sepsis. Because of persistent erythema of the skin under therapy with different immunosuppressives we performed a therapy with high-dose intravenous immunoglobulins. After application of immunoglobulins we observed an improvement of the erythema after 10 days, which was persistent after dose reduction for about 4 months.
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PMID:[Immunoglobulin therapy for systemic lupus erythematosus]. 834 81

An in vitro model was employed to study the potential role of streptococcal extra-cellular products, rich in streptolysin O, in cellular injury as related to streptococcal infections and post-streptococcal sequelae. Extra-cellular products (EXPA) rich in streptolysin O were isolated from type 4, group A hemolytic streptococci grown in a chemostat, in a synthetic medium. EXPA induced moderate cytopathogenic changes in monkey kidney epithelial cells and in rat heart cells pre-labeled with 3H-arachidonate. However very strong toxic effects were induced when EXP was combined with oxidants (glucose oxides generated H2O2, AAPH-induced peroxyl radical (ROO.), NO generated by sodium nitroprusside) and proteinases (plasmin, trypsin). Cell killing was distinctly synergistic in nature. Cell damage induced by the multi-component cocktails was strongly inhibited either by micromolar amounts of gamma globulin, and Evan's blue which neutralized SLO activity, by tetracycline, trasylol (aprotinin), epsilon amino caproic acid and by soybean trypsin inhibitor, all proteinase inhibitors as well as by a non-penetrating PLA2 inhibitor A. The results suggest that fasciitis, myositis and sepsis resulting from infections with hemolytic streptococci might be caused by a coordinated 'cross-talk' among microbial, leukocyte and additional host-derived pro-inflammatory agents. Since attempts to prolong lives of septic patients by the exclusive administration of single antagonists invariably failed, it is proposed that the administration of 'cocktails' of putative inhibitors against major pro-inflammatory agonizes generated in inflammation and infection might protect against the deleterious effects caused by the biochemical and pharmacological cascades which are known to be activated in sepsis.
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PMID:Gamma globulin, Evan's blue, aprotinin A PLA2 inhibitor, tetracycline and antioxidants protect epithelial cells against damage induced by synergism among streptococcal hemolysins, oxidants and proteinases: relation to the prevention of post-streptococcal sequelae and septic shock. 984 86

The clinical picture with, among other things, muscular swelling, fever and nocturnal sweating in three males aged 30, 37 and 52 years, suggested a neoplasm and sepsis. Ultimately, they were found to suffer from focal myositis, localized nodular myositis and polymyositis, respectively. The ESR and leukocyte counts were increased, the serum creatinine kinase (CK) activity was normal or slightly increased. The symptoms decreased after prednisone treatment. Both localized and generalized inflammatory muscular diseases may be present without the serum CK activity being raised.
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PMID:[Myositis in the presence of slightly elevated creatine kinase values]. 1036 12

Group A streptococcal infections, ranging from necrotizing fasciitis and myositis to toxic shock syndrome, have increased over the last 10 years. We developed the first primate model of necrotizing fasciitis and myositis. Thirteen baboons were inoculated intramuscularly with group A streptococci (GAS). Eleven animals survived for > or = 11 days before sacrifice, and two animals died within 2 days. The site of inoculation of the survivors exhibited an intense neutrophilic influx (stage I), followed by a lymphoplasmacytic influx (stages II and III). This was accompanied by the appearance of markers of an acute and then a chronic systemic inflammatory response. In contrast, the site of inoculation of the two nonsurvivors exhibited intravascular aggregates of neutrophils at its margin with no influx of neutrophils and with extensive bacterial colonization. We conclude that GAS inoculation induces a local and systemic acute neutrophilia followed by a chronic lymphoplasmacytic response; failure, initially, of neutrophilic influx into the site of inoculation predisposes to systemic GAS sepsis and death; and this three-stage primate model approximates the human disease.
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PMID:Staging of the baboon response to group A streptococci administered intramuscularly: a descriptive study of the clinical symptoms and clinical chemical response patterns. 1091 29


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