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

We describe a retrospective case series of postanginal sepsis and Lemierre's syndrome (LS) identified from laboratory records of Fusobacterium necrophorum isolates and from clinical case note review. Some patients presented with sore throat, tonsillitis, quinsy or a septicaemic illness, whereas others presented with symptoms related to metastatic septic lesions with later recognition of the significance of the preceding sore throat. Patients with otitis media and mastoiditis are included in the study. The incidence of postanginal sepsis and LS appears to have increased over the study period (1994-99). The population of patients who had received antibiotics pre-admission has decreased in recent years. Attention is drawn to features which may assist in differentiating this condition from simple viral sore throats not requiring antibiotic therapy. A prospective study of the incidence of this rare but life-threatening condition mainly affecting young people is required in view of the more restricted use of antibiotic treatment for sore throat now recommended.
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PMID:Investigation of postanginal sepsis and Lemierre's syndrome in the South West Peninsula. 1210 95

The newborn has an immune system, very limited in size at birth and its postnatal expansion and maturation takes time. In the meantime the transplacental IgG antibodies from the mother play an important role for the protection of the infant. However, these antibodies act in tissues and induce inflammation and are energy-consuming. In contrast, the milk secretory IgA antibodies stop microbes already on the mucosa preventing infection, tissue engagement and energy loss. In addition, the milk contains many protective factors such as lactoferrin and oligosacharides functioning as analogues for microbial receptors preventing mucosal attachment, the initial step of most infections. As a result, breast-feeding significantly reduces the risk of neonatal septicemia, respiratory tract infections, otitis media, diarrhea, urinary tract infections, infection-induced wheezing and necrotizing enterocolitis. Via several mechanisms it seems that human milk can actively stimulate the immune system of the breast-fed infant. This reduces the risk of infections like otitis media, respiratory tract infections, diarrhea and infection-induced wheezing for several years after the termination of breast-feeding. Furthermore, it seems that breast-feeding decreases the risk of attracting celiac disease and allergic diseases. The latter has been much debated, but a recent critical review of published reports gives good support for long-term protection of allergic diseases, especially in high-risk children.
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PMID:Breast-feeding, a complex support system for the offspring. 1213 55

The occurrence of reported cases of AIDS in children in Uganda, and the most common symptoms are discussed. By May 1988, 359 cases of AIDS in children has been reported. All but 12 were in babies less than 2 years of age, suggesting that maternal transmission, rather than casual contact, had caused the infection. Information was available on HIV status of 224 mothers. 42% of these had AIDS or ARC (AIDS related complex). 85 of 87 mothers whose sera had been tested were positive for HIV. Blood testing is not accurate in children until about 15 months of age, since maternal antibodies persist after birth. The most common symptoms seen in childhood AIDS in Uganda are weight loss, failure to thrive, chronic diarrhea, and repeated, chronic oral thrush (candidiasis). Other indicators are otitis media, generalized dermatitis, tuberculosis, septicemia and meningitis. Less common signs are shingles, Kaposi's sarcoma and Cryptospor meningitis. Some of these clinical findings are common in this area, so it is important to define a working clinical case definition of pediatric AIDS.
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PMID:Uganda: paediatric AIDS. 1228 32

PCT is a new highly sensitive and specific marker of bacterial and fungi infection--to be used in differential diagnosis at Infectious Diseases Departments. Author in this paper presents structure and mechanism of stimulation of PCT as a factor of "early infection's fase" for many infectious agents: bacteria, fungi, viruses and parasites. PCT may be found useful in diagnosing diseases; for ex.: sepsis, meningitis, inflammation of respiratory system, spontaneous bacterial peritonitis (SPB) and other local inflammatory foci (otitis media, endocarditis). PCT level is low in systemic inflammatory response syndrome (SIRS) and multiorgan dysfunction syndrome (MODS) of non-infectious origin (< 0.5 ng/ml), medium in case of localized infections (1.0-2.0 ng/ml) and in severe cases of disseminated infections (sepsis-->SIRS-->MODS) high (approximately 20 ng/ml).
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PMID:[Usefulness of plasma procalcitonin (PCT) estimation to diagnose patients in departments of infectious diseases]. 1292 30

Streptococcus pneumoniae (the pneumococcus) is a major cause of bacterial pneumonia, middle ear infection (otitis media), sepsis, and meningitis. Our previous study demonstrated that the choline-binding protein A (CbpA) of S. pneumoniae binds to the human polymeric immunoglobulin receptor (pIgR) and enhances pneumococcal adhesion to and invasion of cultured epithelial cells. In this study, we sought to determine the CbpA-binding motif on pIgR by deletional analysis. The extra-cellular portion of pIgR consists of five Ig-like domains (D1-D5), each of which contains 104-114 amino acids and two disulfide bonds. Deletional analysis of human pIgR revealed that the lack of either D3 or D4 resulted in the loss of CbpA binding, whereas complete deletions of domains D1, D2, and D5 had undetectable impacts. Subsequent analysis showed that domains D3 and D4 together were necessary and sufficient for the ligand-binding activity. Furthermore, CbpA binding of pIgR did not appear to require Ca2+ or Mg2+. Finally, treating pIgR with a reducing agent abolished CbpA binding, suggesting that disulfide bonding is required for the formation of CbpA-binding motif(s). These results strongly suggest a conformational CbpA-binding motif(s) in the D3/D4 region of human pIgR, which is functionally separated from the IgA-binding site(s).
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PMID:The human polymeric immunoglobulin receptor binds to Streptococcus pneumoniae via domains 3 and 4. 1367 68

The case of a 5 year old boy who had a right petrous bone fracture with right CSF otorrhea and deafness is reported. This child presented, three years after the trauma, a right side otitis media, complicated by meningitis and pneumococcal sepsis, which might have as consequence a left side deafness. The bilateral deafness and the early possibility for cochlear ossification made us decide rapidly on a cochlear implant. Benjamin was then operated for a left side cochlear implant 40 days after contracting meningitis. Two months later, this boy was able to understand a speech without lip reading. Current concepts in the management of petrous bone fractures with CSF otorrhea are reviewed in this report. We also discussed prophylactic attitudes to adopt to reduce the risk of post temporal bone fracture meningitis.
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PMID:Petrous bone fractures in children: risk of meningitis, and indication for early Cochlear implant? 1457 53

Streptococcus pneumoniae infection is a frequent cause of pneumonia, otitis media, meningitis, and septicemia. Pneumococcal surface protein A (PspA) is an important virulence factor on the pathogen surface, and it is known to interfere with complement activation. In this study, flow cytometry was used to study the effects of PspA and antibodies to PspA on the deposition of complement C3 on the surface of a capsular type 3 strain, WU2, and its PspA- mutant, JY1119. Using naive mouse serum as a complement source, measurable deposition of C3 was observed within 4 min on PspA- pneumococci, and the amount of surface-bound C3 accumulated rapidly as the amount of serum was increased. In contrast, very little C3 was deposited on the PspA+ strain. In nonimmune mouse serum, the classical pathway was the dominant activation pathway triggered by PspA- pneumococci. Accordingly, EGTA blocked almost all of the complement activation. Moreover, a significant amount of C3 was still deposited on the PspA- strain when serum from factor B-deficient mice was used. This deposition was not observed on the PspA+ pneumococci, indicating that PspA may inhibit complement deposition via the classical pathway. Furthermore, under the conditions we tested, PspA also inhibited C3 deposition when the classical pathway was initiated by antibodies to capsular polysaccharide. Antibodies to PspA could overcome the anticomplementary effect of PspA, allowing for increased complement activation and C3 deposition onto PspA+ bacteria.
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PMID:Effects of PspA and antibodies to PspA on activation and deposition of complement on the pneumococcal surface. 1468 88

Prophylactic antibiotic use in childhood burns is controversial. The efficiency of antibiotic prophylaxis in 77 pediatric burn patients was evaluated. Forty-seven patients received prophylactic antibiotics (Group AP), while 30 patients received no prophylaxis (Group NP). Age, wound depth, day of admission, mechanism of burn injury, type of dressings were similar for both groups (p > 0.05). Wound infection rates were 21.3 % in Group AP and 16.7 % in Group NP (p > 0.05). S. aureus, Enterobacter spp., P. aeruginosa, and E. coli were the most common microorganisms. Patients with wound colonization and infection had a larger burned total body surface area (BTBSA) in both groups (p < 0.01). Eight patients had clinical sepsis. All but one of the septic patients were from Group AP. Associated infections of the upper and lower respiratory tract (16), urinary tract (7), and otitis media (2) were more common in Group AP. One patient died from sepsis in Group AP. Hospital stays were longer in Group AP (21.7 +/- 16.4 vs. 13.5 +/- 10 days; p < 0.05). Antibiotic prophylaxis in childhood burns does not reduce the rate of wound infection. Age, wound depth and BTBSA are not critical variables for prophylaxis. Reinforcing the use of culture-specific antibiotics for more beneficial and cost-effective results in the treatment of childhood burns is recommended.
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PMID:Prophylactic antibiotic use in pediatric burn units. 1563 Jun 46

Streptococcus pneumoniae causes various human infections such as meningitis, septicemia, otitis media, sinusitis, and pneumonia. Antibiotic resistance has already been reported with increasing frequency worldwide and is spreading. The earliest studies on pneumococcal antibiotic resistance go back to the late 1980s in Turkey. The resistance patterns have elevated with stepwise increments since then. By the beginning of 2005, approximately 40% of pneumococci were resistant to penicillin and nearly one-fifth of resistant isolates present high-level penicillin resistance. This proves that penicillin is still a good alternative for nonmeningeal infections. In addition, no ceftriaxone resistance have been reported in local Turkish studies, but cefuroxime, a second-generation cephalosporin, was recorded to have (10.8-20%) resistance rates. The most frequently assessed antibiotics other than penicillin in Turkish studies include erythromycin (4-19.4%), chloramphenicol (2-10%), clindamycin (2.5-13%) and tetracycline (13-28.6%) and all have various resistance profiles. On the other hand, nearly all or almost all of the isolates evaluated in Turkish studies are susceptible to rifampicin, quinolones, linezolid, quinupristin-dalfopristin and telithromycin. All these non-beta-lactam antibiotics except the tetracyclines are within acceptable limits of empirical approaches. Tetracycline must be used cautiously. In addition, trimethoprim sulfamethoxazole cannot be prescribed in probable pneumococcal infections since more than half of the isolates are nonsusceptible.
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PMID:Antibiotic resistance in pathogenic Streptococcus pneumoniae isolates in Turkey. 1582 40

Streptococcus pneumoniae is a causative agent of otitis media, pneumonia, meningitis and sepsis in humans. For the development of effective vaccines able to prevent pneumococcal infection, characterization of bacterial antigens involved in host immune response is crucial. In order to identify pneumococcal proteins recognized by host antibody response, we created an S. pneumoniae D39 genome library, displayed on lambda bacteriophage. The screening of such a library, with sera either from infected individuals or mice immunized with the S. pneumoniae D39 strain, allowed identification of phage clones carrying S. pneumoniae B-cell epitopes. Epitope-containing fragments within the families of the histidine-triad proteins (PhtE, PhtD), the choline-binding proteins (PspA, CbpD) and zinc metalloproteinase B (ZmpB) were identified. Moreover, library screening also allowed the isolation of phage clones carrying three distinct antigenic regions of a hypothetical pneumococcal protein, encoded by the ORF spr0075 in the R6 strain genome sequence. In this work, Spr0075 is first identified as an expressed S. pneumoniae gene product, having an antigenic function during infection.
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PMID:Discovery of novel Streptococcus pneumoniae antigens by screening a whole-genome lambda-display library. 1690 34


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