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

Treatment of a rare Streptococcus pneumoniae mycotic aneurysm by homograft replacement failed in a 59-year-old patient because of persistent lobar pneumonia. Despite reoperation with replacement of the infected homograft by a fresh one, he finally died of septicemia. This case illustrates that homograft tissue may be infected per continuum and that extensive debridement of periaortic tissue-including major lung resection-and the use of muscle flaps may be necessary in certain circumstances.
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PMID:Homograft failure in mycotic aortic aneurysm caused by Streptococcus pneumoniae. 987 5

Bordetella bronchiseptica rarely causes disease in man, and is an unusual pathogen in animals. It causes a pertussis-like syndrome, but pneumonia and sepsis have been described in the immunocompromised as well as in the immunocompetent. A 53-year-old man with adult-onset diabetes and healed pulmonary tuberculosis presented with lobar pneumonia and rapidly developed septic shock with adult respiratory distress syndrome. He responded well to the combination of piperacillin-tazobactam.
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PMID:[Severe pneumonia caused by Bordetella bronchiseptica]. 1095 17

Streptococcus pneumoniae pneumonia frequently occurs in leukopenic hosts, and most patients subsequently develop lung injury and septicemia. However, few correlations have been made so far between microbial growth, inflammation, and histopathology of pneumonia in specific leukopenic states. In the present study, the pathogenesis of pneumococcal pneumonia was investigated in mice rendered leukopenic by the immunosuppressor antineoplastic drug cyclophosphamide. Compared to the immunocompetent state, cyclophosphamide-induced leukopenia did not hamper interleukin-1 (IL-1), IL-6, macrophage inflammatory protein-1 (MIP-1), MIP-2, and monocyte chemotactic protein-1 secretion in infected lungs. Leukopenia did not facilitate bacterial dissemination into the bloodstream despite enhanced bacterial proliferation into lung tissues. Pulmonary capillary permeability and edema as well as lung injury were enhanced in leukopenic mice despite the absence of neutrophilic and monocytic infiltration into their lungs, suggesting an important role for bacterial virulence factors and making obvious the fact that neutrophils are ultimately not required for lung injury in this model. Scanning and transmission electron microscopy revealed extensive disruption of alveolar epithelium and a defect in surfactant production, which were associated with alveolar collapse, hemorrhage, and fibrin deposits in alveoli. These results contrast with those observed in immunocompetent animals and indicate that leukopenic hosts suffering from pneumococcal pneumonia are at a higher risk of developing diffuse alveolar damage.
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PMID:Pathogenesis of pneumococcal pneumonia in cyclophosphamide-induced leukopenia in mice. 1211 31

A 30-year-old man was admitted to our hospital for left lobar pneumonia with septic shock. Acute left-sided heart failure became evident as sepsis developed. Echocardiography revealed diffuse severe hypokinesis of the left ventricle (LV) and a pulmonary artery catheter showed Forrester subset II hemodynamics. Along with amelioration of sepsis and decrease of the serum concentrations of tumor necrosis factor-alpha and interleukin-6, LV hypokinesis improved. It is suggested that the patient's heart failure may have been due to functional depression of myocardial contractility resulting from a direct effect of the cytokines towards the cardiomyocytes, the so-called "septic myocardial depression".
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PMID:Acute reversible myocardial depression associated with sepsis. 1258 21

Infectious complications in individuals with chronic kidney disease (CKD) pose a significant source of morbidity and mortality. The overall scope of major infectious complications has, however, received little attention even though some of these events may be preventable. We reviewed infectious hospitalization rates in the CKD and end-stage renal disease (ESRD) populations, comparing them with the non-CKD and non-ESRD groups. We also reviewed preventive vaccination rates for influenza, pneumonia, and pneumococcal pneumonia to assess areas of potential improvement. We reviewed the medical literature and present findings based on hospitalization rates for pneumonia, sepsis/bacteremia, and urinary tract infections in the Medicare CKD, ESRD, and non-CKD populations. Vaccination rates were determined from submitted claims for services with specific codes for the vaccinations. Regardless of the primary cause for the development of CKD, primary kidney disease or secondary to hypertension, diabetes mellitus, or other chronic condition, patient outcomes after the development of infections were 3 to 4 times worse than in the non-CKD population. Influenza vaccination rates were 52%, far less than the target of 90%. Pneumococcal pneumonia vaccination rate was only 13.5%, far less than recommended. CKD is associated with significant major infectious complications, which occur at rates 3 to 4 times the general population. Providers can improve prevention by using fewer dialysis catheters and increasing vaccination rates for influenza and pneumococcal pneumonia.
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PMID:Infectious complications in chronic kidney disease. 1681 25

A 30-year-old woman with malnutrition due to alcoholism and eating disorders was found to have acute respiratory distress syndrome (ARDS) and sepsis due to severe Streptococcus pneumoniae pneumonia. S. pneumoniae was detected by an in vitro rapid immunochromatographic assay for S. pneumoniae antigen in urine on the day of admission and by blood culture 2 days after admission. Symptoms and laboratory findings improved after treatment with sivelestat sodium hydrate, antibiotics, and mechanical ventilation. Treatment with sivelestat sodium hydrate also decreased serum neutrophil elastase activity. This case demonstrates the usefulness of early treatment with sivelestat sodium hydrate in ARDS due to severe pneumonia.
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PMID:[Survival by a young woman with malnutrition due to alcoholism and eating disorders and with acute respiratory distress syndrome due to severe pneumonia who showed increased serum neutrophil elastase activity]. 1717 60

To examine the role of myocardial interleukin-6 (IL-6) in myocardial inflammation and dysfunction after burn complicated by sepsis, we performed 40% total body surface area contact burn followed by late (7 days) Streptococcus pneumoniae pneumonia sepsis in wild-type (WT) mice, IL-6 knockout (IL-6 KO) mice, and transgenic mice overexpressing IL-6 in the myocardium (TG). Twenty-four hours after sepsis was induced, isolated cardiomyocytes were harvested and cultured in vitro, and supernatant concentrations of IL-6 and tumor necrosis factor (TNF)-alpha were measured. Cardiomyocyte intracellular calcium ([Ca(2+)](i)) and sodium ([Na(+)](i)) concentrations were also determined. Separate mice in each group underwent in vivo global hemodynamic and cardiac function assessment by cannulation of the carotid artery and insertion of a left ventricular pressure volume conductance catheter. Hearts from these mice were collected for histopathological assessment of inflammatory response, fibrosis, and apoptosis. In the WT group, there was an increase in cardiomyocyte TNF-alpha, [Ca(2+)](i), and [Na(+)](i) after burn plus sepsis, along with cardiac contractile dysfunction, inflammation, and apoptosis. These changes were attenuated in the IL-6 KO group but accentuated in the TG group. We conclude myocardial IL-6 mediates cardiac inflammation and contractile dysfunction after burn plus sepsis.
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PMID:Role of interleukin-6 in cardiac inflammation and dysfunction after burn complicated by sepsis. 1722 Jan 81

OUR CONCLUSIONS FROM THE LITERATURE AND OUR OWN EXPERIMENTS MAY BE SUMMARIZED AS FOLLOWS: I. Blood for bacteriological examination during life should be taken directly from the veins and in considerable quantity. II. Resorption of toxines is the most important feature in cases of sepsis; pyogenie bacteria invade the general circulation in a rather small proportion even of severe eases, and, as a rule, late in the course of the disease. III. A general infection by the pnenmococcus can be demonstrated occasionally in the late stages of acute lobar pneumonia. IV. The value of blood cultures as a means of diagnosis in obscure cases of sepsis is limited by the fact that invasion of the blood by the specific organism cannot be demonstrated during life in the majority of cases. Positive cultures are very valuable; negative cultures do not exclude local septic infections. V. The detection of specific bacteria in the blood of cases of sepsis and of pneumonia gives a very unfavorable prognosis in most cases. VI. General terminal infections with pyogenic cocci occasionally occur as an immediate cause of death in chronic disease. Local infections processes play this part more frequently. VII. As far as our experiments have shown, invasion of the blood by bacteria during the death agony, with subsequent distribution of the genus to the organs by the circulation, is a rather uncommon occurrence. VIII. Owing to the relative infrequency of agonal invasion, we believe that in the majority of cases where the autopsy is performed promptly after death, the bacteria which are found in the organs succeeded in reaching these organs previously to the death agony, and are associated with the course of the disease. IX. The presence of bacteria in the organs of late autopsies is due in many cases to post-mortem extension from one organ to another, and in some cases to the post-mortem growth of small numbers of genus which were distributed to the organs by means of the circulation.
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PMID:CULTURES FROM THE BLOOD In SEPTICAEMIA, PNEUMONIA, MENINGITIS AND CHRONIC DISEASES. 1986 18

1. Rabbits recovering from one attack of experimental pneumonia possess an active immunity. Such animals may subsequently withstand repeated increasing doses of pneumococci intratracheally. 2. Death may supervene after any one of subsequent injections, but it seems to depend partly upon the chronic changes in the cardiorespiratory apparatus. It may at least be said that it is usually unassociated with a septicemia which is an invariable accompaniment of fatal primary lobar pneumonia. 3. The serum from animals actively immunized by the repeated intratracheal inoculations with pneumococci may be used successfully to confer a passive immunity against the homologous organism.
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PMID:STUDIES UPON EXPERIMENTAL PNEUMONIA IN RABBITS : VI. STUDIES IN IMMUNITY. 1986 85

1. Lobar pneumonia has been consistently produced in normal monkeys by the intratracheal injection of minute amounts of pneumococcus culture. 2. The disease produced has been shown to be clinically identical with lobar pneumonia in man. 3. Lobar pneumonia has been produced in the monkey in one instance by experimental contact infection. 4. Normal monkeys inoculated in the nose and throat with large amounts of pneumococcus culture have failed to develop lobar pneumonia though carrying the organism in their mouths for at least a month. They have likewise failed to show any evidence of upper respiratory tract infection. 5. Monkeys inoculated subcutaneously or intravenously with pneumococcus culture have in no instance developed pneumonia, but have either died of pneumococcus septicemia or recovered without localization of the infection in the lungs.
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PMID:STUDIES ON EXPERIMENTAL PNEUMONIA : I. PRODUCTION OF PNEUMOCOCCUS LOBAR PNEUMONIA IN MONKEYS. 1986 9


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