Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sickle-cell disease is a well-recognized clinical entity. The pathophysiology of this hemoglobinopathy has been described in detail by numerous investigators since the first case report appeared in 1910. Orthopaedic manifestations of sickle-cell disease account for much of the morbidity associated with this disorder, including pain, osteonecrosis, arthritis, and sepsis. Effective management of these bone and joint sequelae reflect accurate diagnosis, understanding of this disorder's pathophysiology, and knowledge of available medical and surgical treatment alternatives. In this review, the authors summarize the major orthopaedic manifestations of sickle-cell disease with special emphasis placed upon osteonecrosis and osteomyelitis, since these conditions are the most disabling and serious complications in patients with sickle-cell disease.
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PMID:Orthopaedic manifestations of sickle-cell disease. 223 15

The use of labelled granulocyte scintigraphy is recognized as a reliable method for detecting osteomyelitis and other skeletal sepsis. Tc-99m hexamethyl propyleneamine oxime (Tc-99m HM-PAO), a lipophilic chelate offers the advantages of availability, lower radiation dose and higher image resolution, compared to other labelling agents. We have scanned 36 orthopedic patients with suspected infection, using autologous granulocytes labelled with Tc-99m HM-PAO. In all cases, scans were compared with clinical, microbiological and/or surgical findings. Sensitivity was 94% and specificity was 80%. We therefore believe that Tc-99m HM-PAO leucocyte scanning provides a useful method for detecting osteomyelitis and other skeletal infections.
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PMID:Tc-99m HM-PAO labelled leucocyte scanning for detection of infection in orthopedic surgery. 228 Oct 98

Twenty-one patients older than 60 years of age with septic arthritis were reviewed over a ten-year period. The knee was the joint most commonly involved. Concurrent medical illnesses were noted in the majority of patients, with diabetes mellitus present in 24%. Seventy-one percent of patients had roentgenographic evidence of preexisting joint disease in the affected joint. Most patients were afebrile and had normal white blood cell counts at the time of admission. The erythrocyte sedimentation rate was elevated in all patients tested, with an average value of 79. Despite surgical treatment in the majority of patients, the complication rate was high, with 38% developing osteomyelitis; 14%, secondary osteoarthritis; and 19%, mortality due to sepsis. Septic arthritis in the elderly is difficult to diagnose and carries a poor prognosis despite aggressive management.
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PMID:Septic arthritis in the elderly. 229 80

A retrospective study was performed of 292 infants younger than 2 months of age with a history of fever who received a standardized evaluation and were admitted to the hospital for possible sepsis. The purpose was to correlate the presence of this symptom with subsequent temperature patterns and the rate of serious bacterial infections (SBI). Caretakers reported fever per rectum via thermometer in 244 infants and tactile fever in 48 infants. Of 244 infants with reported fever per rectum, 224 (92%) had fever on presentation or during the subsequent 48 hours of hospitalization; by contrast, only 22 of 48 infants (46%) with reported tactile fever had fever on presentation or during the subsequent 48 hours of hospitalization (P less than 0.0001). Of 26 infants with tactile fever who were afebrile on presentation, none had subsequent fever during hospitalization and only 1 (3.8%) had SBI (urinary tract infection); of 40 infants with reported fever per rectum who were afebrile on presentation, 8 (20%) had subsequent fever during hospitalization and 4 (10%) had SBI (meningitis, bacteremia, osteomyelitis and urinary tract infection). There were a total of 19 infants (6.5%) with SBI; although 5 (27%) were afebrile on presentation (4 with reported fever per rectum, 1 with tactile fever), all 19 exhibited abnormal clinical and/or laboratory features on evaluation which were suggestive of underlying serious infection. Management decisions for young infants with reported fever should be based on both clinical findings and temperature-pattern profiles.
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PMID:Correlating reported fever in young infants with subsequent temperature patterns and rate of serious bacterial infections. 233 95

A 3-month old female infant was transferred from another hospital where she had been hospitalized from the age of 1 month for protracted secretory diarrhea. The diarrhea had begun at birth and was unresponsive to various therapeutic formulas and to total parenteral nutrition (TPN). The parents were consanguineous. There were 6 normal siblings, while 3 siblings had died in infancy, including a sister who had succumbed to protracted diarrhea at the age of 6 months. In our patient duodenal biopsy showed flattening of villi and proliferation of mononuclear cells in the lamina propria. Specific circulating IgG antibodies against gut epithelium were found, as well as thyroglobulin antibodies. Repeated trials of oral feeding were unsuccessful and TPN was required for 8 months. Complications included septicemia, osteomyelitis and acute renal failure. Therapeutic trials with intravenous hydrocortisone, zinc sulphate and metronidazole were unsuccessful and the infant died at the age of 11 months. Intestinal tissue taken postmortem showed nearly absolute flattening of intestinal villi. This is the first report in Israel of intractable infantile diarrhea due to autoantibodies to intestinal epithelium.
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PMID:[Autoimmune enteropathy causing protracted diarrhea]. 235 45

Certain anatomical and physiological features are responsible for the specific clinical presentations of hand infections: The dorsum of the hand possesses a loose mobile areolar layer, whereas the gripping function of the palm has determined the development of a dense, firmly anchored sheet layer of connective tissue. It follows that infections of the dorsum of the hand can spread easily and give rise to extensive cellulitis. This cannot occur on the palmar aspect, where infection always tracks along the path of least resistance into the deep tissues, rapidly reaching the functionally important structures of the flexor compartments, including the subfascial compartments of the deep palmar space and the space of Parona in the forearm. A similar chain of events characterizes infections of the thenar and hypothenar eminences. Distal finger infections around the nail are a separate clinical entity with a considerable risk of running a chronic course and involving bone or the distal interphalangeal joint. In this case the sequence leads form subcutaneous infection or paronychia via bone infection to joint sepsis. There is considerable scope for misdiagnosis of hand infections, and inappropriate conclusions may lead to serious consequences for future function of the hand. The treatment of hand infections is demanding, time-consuming and not infrequently requires the infrastructure of a hospital clinic; therefore, in cases of doubt, early referral is always advisable.
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PMID:[Infection of the hand: a specific disease picture]. 238 40

Some indices of humoral and cellular immunity were studied in 98 patients with diabetes mellitus (DM), complicated with pyoseptic infection (phlegmon, abscess, gangrene of different sites, hematogenic osteomyelitis, furunculosis, sepsis). A course of hyperbaric oxygenation (HBO) was conducted. Multimodality antidiabetic therapy in combination with HBO resulted in the improved general status of almost all DM patients, stimulation of reparative processes and wound defect closure were faster; DM compensation was achieved and ketoacidosis stopped. Normalization of laboratory and clinical indices was accompanied by immunological tests. The use of HBO in multimodality therapy of patients with DM complicated with pyoseptic infection brings about a good therapeutic effect.
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PMID:[Hyperbaric oxygenation in the combined treatment of patients with diabetes mellitus complicated by a suppurative-septic infection]. 239 27

Twenty-seven children with severe staphylococcal sepsis were encountered over a 6-year period in a busy teaching hospital paediatric practice. The clinical manifestations are described, among which anaemia, osteomyelitis, lung infection and purulent pericarditis were most common. Osteomyelitis was particularly severe and multifocal in many of the children, leading to bone and joint deformity in some. Striking features were that all affected children were previously healthy, 83.3% had normal haemoglobin genotype AA and none had homozygous sickle cell haemoglobin SS.
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PMID:Severe staphylococcal sepsis in Nigerian children: a report of 27 cases. 245 17

We present 5 young men who developed acne fulminans. During the acute, febrile illness, all had musculoskeletal symptoms, and X-ray and bone scan examinations revealed that 4 of the patients had osteolytic bone lesions. The disease was resistant to various antibiotics and one patient needed surgical trepanation of the sternum. No evidence of sepsis or bacterial osteomyelitis was found, as all bacteriological cultures proved negative and the tissue reaction was unspecific. The dermatopathogenetic origin of bone lesions in the present patients seems evident, but speculation that the etiology depends on immune mechanisms remains open.
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PMID:Acne fulminans with bone lesions. 245 83

The study aimed at searching whether antibiotic prophylaxis was practised after animal bites, and, in this case, what were the criteria adopted. It was performed by considering 162 outpatients requiring assistance after animal bites at the Antirabies Centre of Rome, Italy. In this circumstances, prevention of bacterial and viral infections is performed by wound detersion, by administering anti-tetanus and anti-rabid prophylaxis where required by italian policy, according to the patient's history. Infectious complications are described in literature as a common consequence of animal bites and include cellulitis, septic arthritis, osteomyelitis and even fatal sepsis. Microorganisms related to these infections are frequently typical of animal oral flora and include aerobic and anaerobic species, such as Pasteurella multocida, DF-2, and Leptospira. It was noted that 58 (35.8%) out of 162 were treated with antibiotic prophylaxis; the most common drug used was amoxicillin, given in 18 cases (31%). The overall results do not show any particular reason for practising or not this prophylaxis. The need of standardising the behaviour of Emergency Services, where a different and unjustified attitude to treat or not patients with antibiotic prophylaxis in order to prevent infectious complications following animal bites was observed, emerges from this study.
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PMID:[Verification of antibiotic treatment after animal bites among patients at the antirabies center in Rome]. 248 34


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