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

The authors have treated 41 cases by Papineau's technique. There were 19 cases of osteitis, and 35 septic non-unions (9 in the femur, 16 in the tibia and 10 in other sites). Twenty-four cases healed, the average follow-up being one year. The causes of failure were analysed. Some are related to the technique itself - sepsis and fractures at the sites of graft removal, inadequate quantities of cancellous bon, long delay in bone union and skin problems particularly in the leg. The indications for this technique are compared with those of other techniques. It is concluded that it is a useful technique; only two patients required amputation.
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PMID:[Failures and limitations of the Papineau technic. A report of 54 cases]. 14 88

Lumbar discovertebral abnormalities thought to be due to endogenous or subclinical trauma were evaluated in 22 cases. These consisted of predominantly lytic areas due to intrabody disc herniation in five cases, broad zones of vertebral body sclerosis due to reactive osteitis in 11, and destruction of the vertebral endplates surrounded by diffuse sclerosis in six. Spinal biopsy and negative bacterial cultures were consistent with the diagnosis in eight cases. Follow-up roentgenograms and further clinical evaluation in the remaining 14 showed either no progression or changes consistent with trauma. Only four cases had a history of exogenous trauma. Intrabody disc herniations usually affected the upper vertebral body with characteristic sparing of the adjacent endplate. The sclerotic lesions tended to occur in the anterior portion of the vertebral body, with the inferior aspect of L4 most frequently involved. These may be confused with osteoblastic metastases, particularly if adjacent disc narrowing is minimal. The lack of progressive vertebral fragmentation helps to distinguish this condition from neuroarthropathy. Lesions characterized by destruction of the vertebral endplates and reactive sclerosis simulate infection; absence of a soft tissue mass and clinical signs of sepsis as well as lack of progression are important differential features.
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PMID:Traumatic lesions of the discovertebral junction in the lumbar spine. 18 33

The case of a two-month -old female infant, who after a severe diarrhoea treated with prolonged intravenous infusion in peripheral veins alternated with total parenteral feeding, developed a Candida albicans septicemia (accompanied by disseminated intravascular coagulation syndrome) is reported. The course of her disease was also complicated by multiple foci of osteoarthritis in both knees, in the left hip and in several long-bones. Radiographically the foci of Candida osteitis appeared as fine erosion of the cortex and minute round areas of osteolysis in the spongiosa, surrounded by a rim of perifocal sclerosis. During the acute stage of Candida sepsis a transitory cellular immunodeficiency was present. Treatment of Candida infection by 5-fluorocytosine was followed by complete recovery.
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PMID:Disseminated arthritis and osteitis by Candida albicans in a two month old infant receiving parenteral nutrition. 40 39

The experience of surgeons in Africa with patients infected with human immunodeficiency virus (HIV) suggests 5 trends: 1) an increased incidence of surgical sepsis--most commonly in the female genital tract, the pleural cavity, large joints, and the anorectal area--in HIV-infected patients; 2) an increase in surgical tuberculosis of spine, bone joints, lymph nodes, and the peritoneal cavity concomitant with an increased incidence of pulmonary tuberculosis in high-incidence countries; 3) impaired healing of wounds, wound breakdown, and the development of skin lesions and ulcers; 4) tumors whose aggressiveness is accelerated by HIV infection; and 5) new pathologies such as nonspecific cystitis, chronic osteitis, and vascular disease. In many cases, HIV infection has not been identified until after hospital patients have demonstrated a rapid, progressive decline after routine surgery. To date, only 1 study has attempted to determine the extent to which HIV infection influences the outcome of surgery. Mortality in an intensive care unit at the University Teaching Hospital in Lusaka, Zambia, differed significantly between HIV-positive and seronegative patients only in terms of pneumonia; however, seropositive patients also have an elevated, albeit nonsignificant, risk of mortality from severe gynecologic sepsis.
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PMID:Surgical pathology of HIV infection: lessons from Africa. 755 18

Before treatment of 181 patients with bone marrow transplantation (BMT) for leukemia, severe aplastic anemia, or metabolic disorders, the oral condition was examined clinically and roentgenologically. Fifty-three patients (29%) had chronic dental infections (osteitis) that needed treatment before BMT. In 10 of 181 cases (6%), BMT was postponed because of oral infections. Septicemia during the neutropenic phase was caused by oral microorganisms (alpha streptococci) in 24 of 59 (41%) patients with microbiologically proven septicemia. Septicemia with alpha streptococci was associated with graft-versus-host disease prophylaxis with methotrexate and subsequent increased frequency of oral ulcerations. No difference was observed in the frequency of reactivation of latent herpes simplex virus infection between different graft-versus-host disease prophylaxis regimens. Reactivation was more frequent in patients conditioned with total body irradiation than in patients conditioned without total body irradiation. Antiviral prophylaxis, with subsequent decreased frequency of oral herpes simplex reactivation, appeared to contribute to a low frequency of septicemia with alpha streptococci.
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PMID:The oral cavity as a port of entry for early infections in patients treated with bone marrow transplantation. 259 18

Imipenem and cilastatin in combination have a broad spectrum in vitro with a strong killing activity on most bacteria. Using a multicenter study design, we investigated 41 patients with moderate or severe infections: septicemia in 18 cases (Gram negative rods in 10, Gram positive cocci in 7 and combination of both in 1), pneumonia in 7, osteitis in 4, soft tissue infection in 7, infection of the genitourinary tract in 6 and miscellaneous infections in the remaining cases (1 abscess of the pancreas, 1 typhoid fever, 1 presumptive endocarditis). All of the bacteria were susceptible to imipenem/cilastatin: MICs ranged from 0.02 to 0.8 mg/l and MBCs from 0.015 to more than 10 mg/l. All patients except one recovered or improved under imipenem/cilastatin. The patient who failed to respond had septicemia due to a methicillin-resistant Staphylococcus aureus with a MBC and MIC above 10 and 0.5 mg/l respectively. Tolerance was outstanding: only 4 patients had adverse effects requiring withdrawal of the drug.
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PMID:[Treatment of moderate or severe infections using imipenem/cilastatin. 41 cases based on a multicenter protocol]. 353 23

We investigated the clinical efficiency and safety of ofloxacin, a new fluoroquinolone, for the treatment of various documented bacterial infections in 26 patients (10 females, 16 males) aged 17 to 84 years. Ofloxacin monotherapy was given orally in a dose of 200 mg twice (25) or three times (1) a day. Antibiotic levels and serum bactericidal activity were measured using a microbiological method on the second and sixth days, before and 2 and 6 hours after a single dose. The infectious episode treated was enterocolitis in 7 cases (5 Shigella, 2 Salmonella), Salmonella septicemia in 9 (7 typhoid fevers and 2 Salmonella minor infections), chronic osteoarthritis in 3 (1 E. coli, 2 S. aureus + P. aeruginosa), a soft tissue infection in 3 (2 S. aureus, 1 E. coli), acute pleuropneumonia in 2 (2 Klebsiella pneumoniae), pyelonephritis with bacteremia in 1 (Klebsiella pneumoniae), and pneumococcal pneumonia with septicemia in 1. Mean duration of therapy was ten days for 23 patients (range 7 to 30 days). The three patients with osteoarthritis were treated for 35, 95 and 270 days respectively. 24 patients recovered free of sequelae or germ carriage. Treatment failed in 1 case of chronic osteitis (S. aureus + P. aeruginosa) and in 1 staphylococcal soft tissue infection. No adverse reactions were observed except a slight increase in transaminases in 3 patients. Peak and through serum ofloxacin levels were 3.70 micrograms/ml and 0.95 micrograms/ml respectively on the second day and 3.25 micrograms/ml and 0.80 microgram/ml respectively on the sixth day.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Evaluation of the use of ofloxacin in the treatment of various infections]. 353 24

Enzyme-linked immunosorbent assays were developed with four purified Pseudomonas aeruginosa extracellular proteins (exotoxin A, elastase, alkaline protease, and phospholipase C) to determine antibody levels in sera from healthy subjects and the serological response in patients colonized or infected with Pseudomonas aeruginosa. Five of 39 burn patients with wounds colonized by Pseudomonas aeruginosa had elevated antibody titers to alkaline protease. Response to the other antigens was found in only a few patients. Pseudomonas aeruginosa infections (septicemia, osteitis, pneumonia etc.) resulted in increased antibody levels to exotoxin A or phospholipase C in 15 of 22 patients. These findings suggest that repeated determinations of antibodies to Pseudomonas aeruginosa exotoxin A and phospholipase C might be used to monitor therapy in certain patients with osteitis and other deep Pseudomonas infections.
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PMID:Enzyme-linked immunosorbent assay for detection of antibodies to Pseudomonas aeruginosa exoproteins. 392 8

In a general survey it is stated that for single Staphylococcus aureus infections, clindamycin is not considered to be a first-line drug. Its chief indication is penicillin allergy. Penetration and accumulation of clindamycin within leukocytes demonstrated in vitro may be of value in the treatment of S. aureus diseases resulting in large abscesses. An insidious risk of the development of Clostridium difficile diarrhoea limits the use of clindamycin in ambulatory long-term treatment of diabetic osteitis and chronic osteomyelitis. Such patients must therefore be carefully checked during clindamycin therapy. In staphylococcal endocarditis treated with clindamycin, relapses and development of resistance have been reported. Mixed staphylococcal and anaerobic infections in skin, subcutaneous tissue, the diabetic foot, bone and joints are primary indications for clindamycin. S. epidermidis infections, especially septicemia and endocarditis, are not suitable for clindamycin therapy due to a high rate of resistance.
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PMID:Clindamycin as an anti-staphylococcal agent--indications and limitations. 659 22

It was not difficult to treat an infected pseudoarthrosis without loss of bone substance by "excision-decortication-drainage" in one stage. Union was obtained in 90% of the cases. The rest required additional bone grafts. In only one case out of 41 was there persistent infection. The problem of infected pseudoarthrosis with loss of bone substance and a sizeable defect was more difficult to solve. None of the several methods of treatment employed were without complications. When the overlying skin defect was large and impossible to close in the presence of persistent sepsis at the pseudoarthrosis defect, Papineau's two stage technique of wide excision first followed by insertion of spongious autologous grafts through the granulating defect, appeared secure with minimal risk of residual osteitis in nearly 90% of the cases. 15% of the cases had poor skin healing, requiring further treatment and 20% (nearly one in five) had a stress fracture through the grafted area. One out of 35 cases had persistent pseudoarthrosis and two had persistent infection. In ten selected cases of infected pseudoarthrosis of the tibia with large skin and bone defect, a one stage method of excision, bone grafting and primary skin cover with a local gastrocnemius flap was attempted. In seven cases, primary skin healing and bone union was achieved, one patient required further bone grafting and two had recurrence of sepsis. If properly planned, this one stage method may be indicated in selected cases of infected pseudoarthrosis of the tibia.
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PMID:Treatment of infected pseudoarthrosis of limbs. 675 13


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