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

Thirty-eight of 125 premature infants who were hospitalized in a neonatal intensive care unit (NICU) had abnormal tympanic membrane mobility compatible with otitis media. Twenty-five of these 38 had received antibiotics within one week of otoscopic examination and were considered to have either serous otitis or partially treated bacterial otitis media; tympanocentesis was not performed in them. Tympanocentesis was performed in the remaining 13 infants who had not received antibiotics. Bacterial otitis media was confirmed in ten of the 13. Either staphylococcal (six cases) or Gram-negative enteric organisms (four cases) were isolated in cultures obtained by tympanocentesis in these cases. The four cases of Gram-negative infections occurred in infants within six weeks of birth. Nasotracheal intubation for more than seven days was significantly correlated with impaired tympanic membrane mobility compatible with otitis media. Otitis media occurs frequently among premature infants who are hospitalized in an NICU, and it should be looked for in any infant in whom sepsis is clinically suspected.
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PMID:Otitis media in the neonatal intensive care unit. 35 21

An office myringotomy is an easily performed, underused procedure which has definite clinical applications. The family physician should become familiar with the technique, its indications and its complications. Indications include otitis media with concomitant meningitis, with matoiditis or with cranial nerve involvement, and otitis media in an immunocompromised patient, in a neonate with signs of sepsis or in a very sick, toxic child. If the incision is made in the lower portion of the tympanic membrane, complications are rare.
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PMID:Myringotomy: a neglected office procedure. 51 78

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

We have presented recommendations for diagnosis and management of otitis media in children based on a comprehensive review of the pertinent medical literature. For an entity that is so common, there still remain amazingly large numbers of areas of controversy. We have also attempted to stress the importance of appropriate therapy and adequate followup as being very important in the management of otitis media. Newer concepts, particularly the use of the impedance bridge tympanogram, have been mentioned. With all the above background information in mind and with considerations for what is practical for the patient and the medical community, we would recommend the following as the acceptable minimal care for patients with otitis media. When the diagnosis of the acute otitis media is made on the basis of physical findings of myringitis, and/or middle ear fluid, and/or rupture of the tympanic membrane, the following treatment course is advisable: Neonates Culture of middle ear fluid if possible. Ampicillin 200 mg/kg/day intramuscularly. Gentamicin 3/5mg/kg/day intramuscularly. Hospitalize and treat until well and for minimum of seven days. Observe closely for meningitis and other infections and drug toxicity. These should be handled only by physicians experienced in dealing with patients in this age range. Appropriate work-up for septicemia should precede treatment. Switch to specific antibiotic when cultures and sensitivity available. Children. From 2 months to 6 years of age: Ampicillin 50mg/kg/day. Decongestant (if desired). Administer for ten days. Every patient with otorrhea, severe otitis and those not clinically well should be seen for followup ten to 14 days later. They should have a minimum of otologic evaluation including drum mobility. In persistent cases, audiometry and otologic referral are necessary. If patient is allergic to penicillin, erythromycin at 20mg/lb/day may be used. Trimethoprim sulfa may hold promise in the future. Tetracycline is never indicated in this age range because of side effects and high relapse rate secondary to resistant organisms. Patients above 6 years of age: Penicillin pheyoxymethyl 250 mg every six hours for ten days. Decongestant (if desired). Followup and penicillin allergy as above.
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PMID:Otitis media: a review. 87 Oct 68

Neisseria lactamica was isolated from the blood of a pediatric patient who had signs of septicemia and otitis media. Organisms morphologically resembling Neisseria, as well as gram-positive cocci, were seen on a Gram stain of fluid from the middle ear. It is hypothesized that the N. lactamica septicemia was secondary to infection of the middle ear by this organism.
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PMID:Septicemia due to Neisseria lactamica. 97 88

A series of experiments were carried out on 55 guinea pigs in four groups to study the conditions fostering bone resorbin epidermal cysts. The first group had free grafts of canal wall skin applied to the cochlea with and without talc application. The second group had canal skin flaps applied to the cochlea with and without subsequent talc application. The third group had talc applied either to the tympanic membrane or on the cochlea. The fourth group had a canal skin flap inserted into a mucosal pocket in the bulla. The animals were killed three to four months after surgery and the temporal bones were prepared for histology. Epidermal cysts were found at the cochlea in 8 of 55 animals. Cochlear fistulas were found in 6 of 55 animals. The fistulas were associated with epidermal cysts in three cases, otitis media in two cases, and talc granuloma in one case. These experiments show that migrating skin attached to a source of epithelium is capable of inducing bone resorption. Chronic foreign body granulomas and chronic sepsis are also capable of resorbing bone. These three conditions all produce a layer of undifferentiated connective tissue containing chronic inflammatory cells lying against the resorbing bone.
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PMID:Experimental aural cholesteatoma causing bone resorption. 109 43

A previously undescribed fatal multisystem syndrome involving the eyes, ears, lungs, intestines, and kidneys occurred in sibs. They both presented during early childhood with cataracts, otitis media, intestinal malabsorption, chronic respiratory infection, and failure to thrive. Later, they developed recurrent pneumonia (one was shown to have immotile bronchial cilia) and progressive azotemia leading to end-stage renal disease (ESRD) by late childhood. Both died of overwhelming infection (sepsis, meningitis). An autosomal recessive mode of inheritance is proposed since the normal parents were distant cousins, and 4 other sibs were normal.
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PMID:New syndrome involving the visual, auditory, respiratory, gastrointestinal, and renal systems. 144 88

Panipenem/betamipron (PAPM/BP) is a mixture of panipenem (PAPM), carbapenem antibiotic, and betamipron (BP), N-benzoyl-beta-alanine. The adverse reaction to PAPM of the kidney is reduced by the addition of BP to PAPM which inhibits the anion transport in the kidney tubules. We studied the pharmacokinetics and the clinical efficacies of PAPM/BP in children and we evaluated the antibacterial activities of PAPM by determining MIC values of PAPM in vitro against organisms isolated in our children's hospital from January to December, 1990. 1. Pharmacokinetics 10 mg/kg of PAPM/BP (10 mg PAPM/10 mg BP) was administered intravenously by drip infusion to 7 children. The mean blood concentration of PAPM was 14.8 micrograms/ml at the peak, and the mean half life was 0.9 hours in blood. PAPM was not detected in blood 3 hours after the time when the peak values were attained. 2. Clinical studies 10 mg/kg of PAPM/BP was administered intravenously 3 times a day to 18 cases including 15 of respiratory infections, 2 of otitis media and 1 of sepsis. The clinical efficacies of PAPM/BP were excellent or good in 17 out of the 18 cases. All causative organisms isolated in 5 cases, Methicillin-sensitive Staphylococcus aureus (MSSA) (1 case), Streptococcus pneumoniae (1), Haemophilus influenzae (2) and Branhamella catarrhalis (1) were eradicated in a few days upon the administrations of PAPM/BP. No adverse reactions due to PAPM/BP were observed, but a slight elevation of platelet counts in blood was observed in 1 case, which was normalized soon after the end of the treatment. 3. Antibacterial activities in vitro(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Pharmacokinetics and clinical studies of panipenem/betamipron in the pediatric field]. 151 28

We report the first known case of daunorubicin administered directly into the human central nervous system. A 3 1/2-year-old female with pneumonia and otitis media was diagnosed with acute lymphoblastic leukemia and was admitted for antibiotics and chemotherapy. On the first day she inadvertently received a 17 mg intrathecal (IT) injection of daunorubicin. When the error was recognized about 1 hour later, her cerebrospinal fluid (CSF) was exchanged with sterile saline by barbotage, IT hydrocortisone was given, a subarachnoid catheter was inserted, and the CSF was allowed to drain for 36 hours. Only 5.6 mg (33%) of the dose was recovered from CSF, 2.7 mg as daunorubicin and 2.9 mg as the metabolite, daunorubicinol. Initially she was asymptomatic and induction therapy continued with vincristine, 1-asparaginase, prednisone, and IT methotrexate. One week after the daunorubicin injection she developed headache and irritability; CSF protein was 3.2 gm/dl. On the 12th day, she developed fungal sepsis and worsening pneumonia. On the 15th day, she became comatose with a flacid paraparesis, areflexia, and an ascending progressive bulbar palsy. A series of computerized tomography scans over 6 weeks showed increasing diffuse cerebral atrophy. Nerve conduction velocity studies were consistent with an axonal neuropathy. Despite her multiple concurrent medical problems, the timing and characteristics of neurologic damage suggest that IT daunorubicin caused progressive destruction of the nervous system.
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PMID:Inadvertent intrathecal injection of daunorubicin with fatal outcome. 157 39

A specific form of chronic epitympanitis has been identified in children. This pathology includes tympanic membrane perforation above he lateral process of the malleus and is termed cholesteatomic epitympanitis . This is because it is accompanied by epidermis growth across the perforation into Prussak's space. This form of epitympanitis occurred in 40 (75%) children out of 53 cases operated during 10 years. It is underlined that this pathology can hardly be diagnosed since it often develops together with sclerosis of mastoid cells. These children had frequent recurrent otitis media. An immediate cause was Eustachian tube closure, often with adenoid vegetations. Adenotomy was performed in 17 (42.5%) children. All patients underwent radical surgery; 16 showed large cholesteatoma, 5 developed intracranial complications, 2 of whom had sinus thrombosis and sepsis. One of operative findings was delineation of the attic from the mesotympanum and the tympanic ostium of the Eustachian tube.
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PMID:[Characteristics of the clinical course and treatment of epitympanitis with cholesteatoma in children]. 175 90


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