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

Urinary tract infections are common clinical problems which result in significant morbidity and even mortality. UTI's can range from minimal disease to life-threatening sepsis and it is important to differentiate between the former which usually involves the lower urinary tract and the latter which invariably involves the upper urinary tract. Diagnosis depends on an abnormal urine microscopy and demonstration of bacteria in the urine. Pre-therapy urine cultures are not mandatory in young women with uncomplicated UTI and many studies support the efficacy of short-course therapy in this groups of patients. For other patients, microbiological and radiological investigations are required and there is insufficient data to support short course therapy in these patients. Treatment guidelines are different in special situations such as prostatitis, pregnancy, catheter-related infection and recurrent infections.
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PMID:Urinary tract infections. 855 1

Mucosal immunity was established in the rat prostate by stimulating the common mucosal system through serosal exposure of formalin-killed Escherichia coli. Immunized but not sham-immunized rats developed bacterial specific IgG and IgA in prostatic fluid, and IgA in urine. Immunized (n = 21) and sham-immunized control rats (n = 30) were challenged by transurethral injection of E. coli into the prostate ducts. Mortality, gross and microscopic pathology, tissue bacterial counts, bacterial associated immunoglobulins, and antibody titers in serum and urine were assessed at 7 days following the challenge. Increased E. coli specific immunoglobulin titers were seen in immunized rats, and E. coli, but not Proteus, found in the prostates of immunized animals were coated with IgG and IgA. Immunization protected against toxaemia and septicemia, seen as a rare complication of acute prostatitis, but did not protect against acute prostatitis, nor alter the degree of tissue damage seen in the rat model.
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PMID:Specific mucosal immunity in the pathophysiology of bacterial prostatitis in a rat model. 1090 22

A short version of the UTI Guidelines elaborated by the Urinary Tract Infection Working Group of the Health Care Office of the European Association of Urology is presented. The topics include classification, diagnosis, treatment and follow-up of uncomplicated UTI, UTI in children, UTI in diabetes mellitus, renal insufficiency, renal transplant recipients and immunosuppression, complicated UTI due to urological disorders, sepsis syndrome, urosepsis, urethritis, prostatitis, epididymitis, orchitis and principles of perioperative prophylaxis in urology.
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PMID:EAU guidelines for the management of urinary and male genital tract infections. Urinary Tract Infection (UTI) Working Group of the Health Care Office (HCO) of the European Association of Urology (EAU). 1175 70

Trimethoprim-sulfadiazine (TMP-SDZ) (Tribressin tablets 120 - 100 mg sulfadiazine, 20-mg trimethoprim [Coopers Animal Health, Inc., A Pitman-Moore Company, Mundelein, Ill.]) is a broad spectrum antibiotic combination effective in the treatment of bacterial pneumonia, urinary tract infections, pyoderma, meningitis, and prostatitis.(1) In clinical trials in puppies and adult dogs, TMP-SDZ was considered safe at both the manufacturer's recommended dose (15 mg/kg, b.i.d., or 30 mg/kg, u.i.d., per os for < 14 days(2)) and at 10 times that dose for 20 dayS.(3) Many infections, however, require prolonged high-dose therapy for resolution. The following study describes two cases of aplastic anemia and sepsis associated with intermittent, chronic (17-25 days), high-dose (25-30 mg/kg, b.i.d., per os) TMP-SDZ therapy recommended for the treatment of pyoderma.(4-7)
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PMID:Aplastic anemia associated with prolonged high-dose trimethoprim-sulfadiazine administration in two dogs. 1266 95

Uropathogenic Escherichia coli is the most common cause of urinary tract infection (UTI). Cystitis in women is by far the most common UTI; pyelonephritis in both sexes and prostatitis in men are more severe but are less frequent complaints. The ability of E. coli to cause UTI is associated with specific virulence determinants, some of which are encoded on pathogenicity islands (PAI). One such PAI (PAI IICFT073), of the prototypical uropathogenic E. coli strain CFT073, contains 116 open reading frames, including iron-regulated genes, carbohydrate biosynthetic genes, the serine protease autotransporter picU, a two-partner secretion system, a type I secretion system, mobility genes, and a large number of hypothetical genes. To determine the association of PAI IICFT073 with UTI, PCR was used to examine the prevalence of the five virulence-associated loci among the ECOR collection and a collection of E. coli isolated from patients with cystitis, pyelonephritis, prostatitis, or septicemia. All PAI IICFT073 loci were found to be more prevalent among the B2 phylogenetic group than any other group within the ECOR collection and among invasive prostatitis strains than were cystitis or pyelonephritis strains. These data support the theory that clinical isolates causing prostatitis are more virulent than those producing cystitis or pyelonephritis in women.
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PMID:Prevalence of pathogenicity island IICFT073 genes among extraintestinal clinical isolates of Escherichia coli. 1587 76

A case of a asymptomatic prostatitis due to Candida Albicans that caused a sepsis is presented. Up today in literature only 3 cases of Candida infections of the prostate gland without general illness were described. In this case the transurethral electro-resection of prostate was the adequate treatment.
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PMID:Sepsis due to asymptomatic Candida prostatitis. 1637 10

The aim of this study was to assess infectious complications in transrectal ultrasound-guided prostate biopsy (TRUSPB), comparing two groups of patients: one group with antibiotic prophylaxis and the other without prophylaxis. A total of 1,018 TRUSPBs were performed from April 1996 to July 2003. No antibiotic prophylaxis was given in the first 614; the remaining 404 procedures were performed under antibiotic prophylaxis. Biopsy complications were assessed at outpatient urologist visits after the procedure in the 212 first biopsies and by telephone interview in the remaining 806. A total of 78 infectious complications were found. Major infectious complications (n=41) were septic shock (n=3), sepsis (n=3), Fournier gangrene (n=1), urinary tract infection (n=2), and fever requiring hospital admission (n=32). Minor infectious complications were fever that did not require admission (n=29), prostatitis (n=6), and epididymitis (n=2). Infectious complications occurred in 63 of 614 (10.3%) procedures without antibiotic prophylaxis and in 15 of 404 (3.7%) of those with antibiotic prophylaxis (P=0.0001). Of the 41 major infectious complications, 31 (75.6%) occurred in procedures without antibiotic prophylaxis (n=583) versus ten (24.4%) in those with prophylaxis (n=394) (P=0.0410). In conclusion, transrectal ultrasound-guided biopsy of the prostate has a statistically significant higher risk of infectious complications when performed without antibiotic prophylaxis.
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PMID:Transrectal ultrasound-guided prostate biopsy: is antibiotic prophylaxis necessary? 1639 4

A 65-year-old man with diabetes mellitus reporting fever and urination disturbance on a flight from Bangkok back to Japan in July 2003 was admitted elsewhere for acute prostatitis. Despite intravenous antibiotics, his condition deteriorated. On admission to our hospital, he suffered from respiratory failure, with laboratory data showing disseminated intravascular coagulation (DIC). Computed tomography (CT) shows infiltrative and nodular shadows in both lung fields and low-density areas in the left kidney and prostate gland, consistent with pneumonia and abscesses in these organs. He also developed broad osteomyelitis in the right lower extremity with cellulitis and arthritis in the right hand, knee, and foot. Blood, urine, and joint fluid culture all yielded Burkholderia pseudomallei, so he was diagnosed with melioidosis. Treatment was started with meropenem and minocycline, then meropenem was changed to imipenem. His symptoms gradually improved after ciprofloxacin was added, so all intravenous antibiotics were discontinued and he underwent oral treatment with chloramphenicol, minocycline, and sulfamethoxazole/trimethoprim in September 2003. He developed fever again, however, and oral therapy was discontinued and intravenous antibiotics restarted. After resolution of fever, oral maintenance therapy was initiated again with levofloxacin and minocycline in October, and his condition remained stable. After discharge in April 2004, he has been followed up with no evidence of relapse. This is considered to be the seventh case of melioidosis reported in Japan. Our patient manifested multiple organ lesions with sepsis and DIC, and was difficult to treat, but clinical symptoms improved in long-term antibiotic administration. With travelers to Southeast Asia increasing, greater attention must be paid to imported infectious diseases, such as melioidosis.
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PMID:[A Japanese case of melioidosis presenting as multiple organ lesions accompanied by sepsis and disseminated intravascular coagulation, after a visit to Thailand]. 1756 19

The records of five previously healthy adult patients with primary and secondary purulent pericarditis are reported, in order to review the literature about such a rare condition and to discuss the options for treatment. Primary purulent pericarditis occurred in a five months pregnant woman and in a lady who had experienced a serous pericarditis two months before. A man presented with pyo-pneumo-pericardium. He had an episode of acute prostatitis 30 days before. Two further patients had purulent pericarditis secondary to pulmonary and mediastinal infections. The diagnosis was made late in all cases, after tamponade and shock occurred. Pre-operative catheter drainage failed to prevent recurrent tamponade and sepsis in two patients. All patients underwent thoracotomy and partial pericardiectomy. A downward transdiaphragmatic spreading collection was evident in one patient and laparotomy was needed. The mean postoperative stay was 30.4 days (20-48 days). All patients were discharged home in good health. The lady who was pregnant experienced an uncomplicated vaginal delivery. The follow-up time ranged between 5 months to 12 years. No patient has signs of pericardial constriction. We conclude that effective control of sepsis and prevention of possible further constriction are achieved safely by open surgical drainage and partial pericardiectomy.
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PMID:Primary and secondary purulent pericarditis in otherwise healthy adults. 1767 Jun 71

Prostate infection caused by Aeromonas sobria has not been reported in the literature. We presented a 44-year-old healthy man with a habit of alcoholic consumption who was admitted because of primary A. sobria prostatitis with septicemia. The patient was successfully treated with intravenous ofloxacin and was uneventful after a half-year follow-up. Based on our rare case, we suggest to clinical physicians that prostatitis might be considered in healthy male patients with A. sobria bacteremia and a vague primary infection focus.
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PMID:Aeromonas sobria prostatitis and septic shock in a healthy man with chronic alcoholic consumption. 1803 45


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