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

We report a rare case of odontogenic abscess, detected while the patient was in the intensive care unit (ICU), which resulted in sepsis and the patient's death due to mediastinitis, skull osteomyelitis, and deep neck cellulitis. The detection of infectious focus in occult sepsis in ICUs is usually difficult because many diagnostic procedures cannot be conveniently performed. The use of 99mTc-hexamethylpropyleneamineoxime-labeled white blood cells scan allowed accurate diagnosis and appropriate surgical drainage.
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PMID:Spread of infectious complications of odontogenic abscess detected by technetium-99m-HMPAO-labeled WBC scan of occult sepsis in the intensive care unit. 173 49

Complications caused by placement of a fetal scalp electrode include trauma, hemorrhage and infection. Infections are usually localized and self-limited, but they can occasionally lead to serious complications, such as osteomyelitis, sepsis and death. The recommended treatment for a scalp abscess is incision and drainage, followed by appropriate antibiotic therapy. If a serious infection is suspected, the infant should be hospitalized, blood cultures obtained and intravenous antibiotic therapy initiated.
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PMID:Infection of fetal scalp electrode monitoring sites. 173 43

Twenty cases of osteomyelitis and/or septic arthritis caused by multiply resistant Staphylococcus aureus were documented in an Australian tertiary neonatal unit between 1981 and 1987. Eighteen (90%) occurred in the 3 years 1985 to 1987, an incidence of 9.6/1000 admissions in that period. All osteomyelitis and/or septic arthritis occurred in sick premature infants requiring intensive support. Eleven (55%) had a birth weight of less than 1500 g. An intravascular device was the most common portal of entry (14 of 20, 70%). Systemic symptoms were prominent at presentation, with local signs developing later in 18 (90%), usually within a week. Radiologic changes were almost always present by 10 days; radionuclide bone scanning was insensitive and did not hasten diagnosis. Osteomyelitis was multifocal in 11 cases (55%), with the long bones, particularly of the upper limb, most commonly affected. Large joint involvement was uncommon (15%). Intravenous vancomycin for a mean of 32 days was associated with low mortality (1 of 20) and toxicity; surgical drainage was not performed. Follow-up at a minimum of 4 months (mean, 25.5 months) showed residual signs in the affected limb in 30%, none with significantly impaired function. Skeletal infection should be searched for rigorously in neonatal multiply resistant S. aureus sepsis. In the absence of large joint disease, vancomycin therapy alone for a minimum of 3 weeks gives good short term results with minimal toxicity.
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PMID:Bone and joint infections caused by multiply resistant Staphylococcus aureus in a neonatal intensive care unit. 174 Dec 3

Risk factors, clinical syndromes and the case-fatality rates associated with Group B Streptococcus (GBS) infections in infants managed at the University of Rochester Medical Center during 1979 to 1989 were reviewed. Overall 92 episodes of early onset disease (EOD) and 54 of late onset disease (LOD) were diagnosed in 143 infants (3 infants with EOD presented later with LOD). About one-third of patients with EOD and controls were non-white compared with two-thirds of patients with LOD that occurred in racial minority groups. Prematurity and low birth weight were significantly more common in patients with invasive GBS disease than in controls. Eighty-three of 92 (90%) cases of EOD were detected during the first day of life and 10 of 54 (19%) cases of LOD occurred in infants older than 3 months of age. At the time of diagnosis 4% of infants with EOD were asymptomatic, 54% had respiratory disease, 27% had sepsis without a focus, 15% had meningitis and 1% had urinary tract infection or omphalitis. Among infants with LOD 46% had sepsis, 37% meningitis, 7% urinary tract infection, 6% osteomyelitis and/or septic arthritis and 4% cellulitis or pneumonia. Leukopenia and shift to the left were observed in 43 and 61% of episodes of EOD and in 28 and 57% of episodes of LOD, respectively. All infants were promptly treated with antibiotics and vigorous supportive therapy. The case-fatality rate was 13% in EOD and 0 in LOD.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The changing spectrum of group B streptococcal disease in infants: an eleven-year experience in a tertiary care hospital. 174 91

Cellular antigens extracted from the cells of four Staphylococcus aureus strains from different kinds of infections (sepsis, osteomyelitis, furunculosis) were analysed by the western blotting technique. Antibiotic sensitivity pattern of the strains was compared. One isolate was found to be MRSA strain. Sera samples from patients of whom strains were isolated and four sera from blood donors (as a control) were used in the investigation. IgG levels for purified staphylococcal antigens (lipase, alpha-toxin and teichoic acid) were estimated. Interaction between extracted bacterial antigens and serum antibodies of IgG class were analysed in homologous and heterologous systems. The most strong immunological reaction of the investigated sera with staphylococcal antigens was observed in the case of homologous system. Serum from sepsis patient was found to be the most reactive serum with all staphylococcal antigens mixtures.
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PMID:[Humoral response to Staphylococcus aureus antigens evaluated by the western blotting method]. 178 33

A 54-year-old man received insertion of an acupuncture needle into the region extending from the posterior neck to the back on two occasions for the treatment of shoulder stiffness. Two weeks after the second acupuncture, he developed fever, dysarthria and mictionary disturbance, finally reaching the condition of tetraplegia. He was immediately admitted to an emergency room in our hospital, and was diagnosed as sepsis with DIC, ARDS, heart failure, renal failure, liver failure, and myelitis. After one month, he recovered with transverse myelopathy as a residual deficit. Neurological findings showed transverse myelopathy below the level of Th2 at that time. Cervical CT revealed an irregular low density at the periphery of the cervical vertebra from the C2 to C4 level. Cervical MRI revealed an irregular swelling of his spinal cord from the C2 to C7 level. We explained the mechanism of transverse myelopathy in this case as follows. After the acupuncture, he suffered a focal infection of the region of needle insertion, and then the infection expanded to the cervical vertebra, thus causing osteomyelitis, sepsis, and finally cervical myelitis. Direct injury of the spinal cord and nerve roots as a complication of acupuncture was previously reported, but indirect injury of the spinal cord due to myelitis had not been reported except our present case. Careful attentions should be paid to the complications of acupuncture.
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PMID:[A case of transverse myelopathy caused by acupuncture]. 178 54

The article deals with experience in the treatment of 295 patients with hematogenous osteomyelitis, who accounted for 51.4% of adult patients with various forms of osteomyelitis. In 15.4% the acute stage of the disease was complicated by sepsis. A recurrence in chronic disease was encountered in 42% of cases. In view of this, postoperative pyoseptic complications were analysed and the main ways for their reduction defined. Early opening of the medullary canal in patients with acute hematogenous osteomyelitis and expansion of the scope of resection in chronic forms have a favourable effect on the prognosis of the disease. Recovery was registered in 74.2% of cases after sequestrnecrectomy and in 94.6% of cases after tubular bone recanalization. Thus, patients with hematogenous osteomyelitis must be treated at specialized departments with early hospitalization if acute hematogenous osteomyelitis is suspected. Operation, ranging from sequestrnecretomy to possible bone extirpation, is still the preferred method in chronic forms of the disease.
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PMID:[Prognosis and prevention of postoperative suppurative-septic complications of hematogenic osteomyelitis]. 180 6

Over a period of 60 months 137 cases of intestinal and extra-intestinal salmonellosis were registered in the microbiology department of the Ivrea-Castellamonte hospital. The authors conducted a retrospective study relative to the extra-intestinal salmonellosis manifested in elderly patients. In order to carry out such a study the authors considered only patients who were in the hospital, who were over the age of 65, and who had a clinical history different from the usual one of gastroenterocolitis. Out of 61 patients who were in hospital 50 were with complete registration data; 9 (18%) were over 65 years of age. The analysis of the clinical cards permitted the identification of 4 cases with unusual clinical histories due to the presence of serious systemic complications (sepsis with prolonged fever and positive blood cultures) or focal infections in extra-intestinal tissues (abscess of soft tissues, osteomyelitis). The authors focused their attention on these and described the general clinical characteristics of each patient, the type and the position of the isolated microorganism, the manifestations or extra-intestinal complications of the infection and the predisposing factors regarding the same complications. For each patient the essential clinical history and the treatment of the disease have been described. The authors conclude by affirming that in the cases of elderly patients with salmonellosis, apart from those infections in positions different from intestinal one, it would be opportune to consider an antimicrobe treatment also for enteritis infections and cases of asymptomatic infection.
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PMID:[Bacteremia and localized suppurative Salmonella non-typhi infections in the elderly: a study of 4 cases observed at the Ivrea-Castellamonte Hospital]. 184 23

Many discriminative experimental animal models of infection have been utilized in the evaluation of newer fluoroquinolones. In vivo efficacy of many of the newer agents has been shown in experimental models of meningitis, endocarditis, pneumonia, urinary tract infections, pyelonephritis, osteomyelitis, abscesses of various types, septic arthritis, gastroenteritis, salmonellosis, listeriosis, tuberculosis, syphilis, sinusitis, prostatitis and burn wound sepsis, among others. This review focuses on recent developments in a few selected areas. Although the limitations of animal model studies are well described, these results provide a rationale for the appropriate clinical usage of the newer fluoroquinolones in humans.
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PMID:Evaluation of quinolones in experimental animal models of infections. 186 88

Pressure is the primary pathogenic factor in the development of ulcers but other major factors are shearing forces, friction and moisture. Significant risk factors are immobility, nutritional status and age-related diseases. Complications of pressure ulcers can be life threatening. The authors wish to stress preventive measures and also recommend a therapeutic approach based on the grade of ulcer present. Prevention is best achieved by identification of high risk patients, alleviation of causative and predisposing factors and early detection of ischemic skin changes. The treatment includes local wound care that eliminates necrotic tissue, decreases bacterial load and provides a physiologic environment allowing the wound to heal, and systemic treatment: adequate nutrition, correction of underlying illnesses and systemic antibiotics (in case of sepsis, cellulitis, osteomyelitis or the prevention of bacterial endocarditis).
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PMID:[Prevention and treatment of pressure ulcers]. 192 76


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