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

We studied 182 sick, febrile (temperature greater than 38 degrees C) infants less than 3 months of age, who presented at our Tripler Army Medical Center, Honolulu, during a one-year period, to determine the relative causes of fever in this age group. Blood, cerebrospinal fluid, urine, nasopharyngeal secretions, and stool specimens were cultured for bacterial and viral pathogens. Paired acute and convalescent sera were collected to serologically confirm infection in infants from whom viral isolations were obtained only from the nasopharynx or stool. A viral pathogen was isolated in 75 infants (41%) and a bacterial pathogen was isolated in 27 infants (15%). Nonpolio enteroviruses were the most common pathogens demonstrated. They were isolated from 64 infants (35%), and 40 (62%) of these infants had aseptic meningitis, the most frequently made diagnosis. Urinary tract infection was the most common bacterial infection observed. It occurred in 20 infants (11%) and was most often seen without associated pyuria in uncircumcised male infants. Salmonellosis, the second most common bacterial infection, was observed in six infants (3%), and two of these did not have diarrhea or other gastrointestinal tract symptoms. No infant had septicemia and only one infant had bacterial (group B streptococcal) meningitis.
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PMID:Bacterial and viral pathogens causing fever in infants less than 3 months old. 403 21

Overwhelming infections caused by encapsulated bacteria, salmonella spp. and Plasmodium falciparum (in malarious areas) are an important cause of morbidity and death in patients with sickle cell disease. Bacterial infections afflicting these patients include fulminant meningitis and septicaemia caused by Str. pneumoniae and H. influenzae type b, and non-typhoid salmonellosis. Children less than five years of age are at greatest risk for meningitis and septicaemia, while salmonella osteomyelitis is probably common to all age groups. The most important contributing factors to this increased susceptibility to encapsulated bacteria are: a state of functional asplenia, an opsonophagocytic defect due to an abnormality of the alternative complement pathway, and a deficiency of specific circulating antibodies. Devitalisation of gut and bone due to repetitive vaso-occlusive crises, saturation of the macrophage system with red cell breakdown products of chronic haemolysis, and underlying splenic and hepatic dysfunction all predispose to salmonella infections. Seventy per cent of septicaemias and meningitis among under-fives with sickle cell disease is caused by Str. pneumoniae. Septicaemia frequently presents with sudden fever, few prodromal features, and a deceptive appearance of well-being, followed within hours by rapid relentless progression to shock and death. Adrenal haemorrhage is common, and mortality can be as high as 50 per cent, unless intravenous antibiotic, with or without steroid therapy, is promptly initiated. The clinical presentation of bacterial meningitis, its management and mortality follow the normal patterns, but recurrent meningitis and cerebrovascular morbidity are common in patients with sickle cell disease. An acute pulmonary involvement, indistinguishable from bacterial pneumonia (the 'chest syndrome') is the commonest single complication of sickle cell disease at any age. Str. pneumoniae is responsible for about half of the episodes. The protective values of the pneumococcal vaccine and long-term penicillin prophylaxis remain to be established in sickle cell disease. Over 70 per cent of haematogenous osteomyelitis in sickle cell disease is caused by salmonellae. The distinction from vaso-occlusive bone crisis is often difficult, but the presence of multiple, often symmetrical bone involvement, diaphyseal fissuring and involucrum should suggest osteomyelitis rather than bone infarction. Chloramphenicol remains the drug of choice and often has to be given in high doses for up to six weeks. The role of surgery is limited by the presence of multiple bone involvement and the known anaesthetic risks in this group.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Sickle cell disease and infection. 631 9

T-1982 (cefbuperazone) was evaluated in 25 children with a suspicion of bacterial infections, of the 21 confirmed bacterial infections, 18 were shown to be effective (efficacy rate, 85.7%). The diagnosis included pneumonia (4), bronchopneumonia (3), acute bronchitis (4), acute pharyngitis (1), acute laryngitis (1), acute epiglottitis (1), acute enterocolitis (3), cervical lymphadenitis (1), acute pyelonephritis (1) and suspected septicemia (2). The etiologic pathogens recovered were Haemophilus influenzae (4), Staphylococcus aureus (2), Salmonella typhimurium (1), Salmonella subgenus (1), and enteropathogenic Escherichia coli (2). Among these strains, 7 strains were eradicated after treatment. A case of suspected septicemia and 2 cases of acute enterocolitis with Salmonella infection were not effectively treated with T-1982. The serum half-life of T-1982 was 1.2 hours after an intravenous bolus injection. No severe adverse reaction was encountered with the T-1982 therapy. The data suggest that T-1982 is an effective and safe parenteral antibiotic in the treatment of susceptible pediatric bacterial infections.
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PMID:[Clinical evaluation of T-1982 (cefbuperazone) in the pediatric infections]. 634 35

Five focal non typhoid salmonellosis (NTS) are reported in a group of 342 kidney transplant recipients. There is no relationship between the unusual presentation of NTS (septicemia, pneumonia, orchitis, prostatis, urinary tract infections) and the serotypes (S. typhi-murium, S. panama). With the therapeutic immunodepression, many host factors are important to induce the unusual presentation of NTS: major surgery, urologic abnormalities, preexisting uraemic state. The major importance of decreased host resistance is emphasized by the absence of relationship between death and bacterial resistance. The use of lysotypes exclude the role of an intrahospital contamination.
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PMID:[Extradigestive forms of nontyphoid salmonellosis in renal transplant patients: 5 cases]. 636 9

Clinical and laboratory data of 27 previously normal, healthy infants 2 months of age or less who were hospitalized for suspected sepsis during a 1-year period were reviewed. Results of bacterial cultures and viral studies revealed enteroviruses (seven echoviruses, one coxsackievirus) to be the predominant pathogens identified. Other viruses identified were one each of adenovirus, untypeable hemadsorbing virus and respiratory syncytial virus. Group B streptococcal and enterococcal bacteremia and salmonellosis were diagnosed in one case each. Gram-negative bacillary urinary tract infections occurred in two patients. No pathogens were identified in 11 patients. Although these data indicate an important role for enteroviruses in this syndrome during summer and fall, we believe that the occult bacteremia found in 7% of our patients justifies initial antibiotic therapy in very young infants with suspected sepsis.
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PMID:Viral and bacterial pathogens of suspected sepsis in young infants. 688 56

Salmonellosis in older children and adults is usually a self-limited disease, but the risk of complications in infants is not well-defined. We performed a retrospective review of 52 patients. 90 days of age or less, seen at the St. Louis Children's Hospital between 1975 and 1981 with stool cultures positive for salmonella. Sixteen were 30 days old or less (neonates), 21 were 31- 60 days of age, and 15 were 61-90 days old. Among patients in whom blood cultures were done initially, bacteremia was most frequent in neonates: 5/11 (45%), compared to 2/18 (11%) in older infants. All seven infants presenting with bacteremia received 10 or more days of antibiotic therapy: yet complications (osteomyelitis, fatal meningitis or chronic diarrhea) developed in three of five neonates and one of two older infants. Complications also developed in seven of 22 patients who initially had negative blood cultures, including two infants in whom sepsis later developed and two infants who required intravenous hyperalimentation because of chronic diarrhea and malnutrition. The group of 23 patients who did not have blood cultures all did well. Salmonellosis is not necessarily a self-limited infection in young infants. Even in the absence of bacteremia, clinicans would appear to be justified in using antimicrobial therapy in infants 3 months of age or les with salmonella gastroenteritis, particularly neonates of older infants with symptoms of dysentery or failure to thrive.
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PMID:Salmonella gastroenteritis in the first three months of life. A review of management and complications. 714 Jan 21

Of seven infants with Salmonella sepsis, three had meningitis. A review of these cases and others previously reported demonstrated that among infants less than 1 year old in Arkansas, Salmonella infection developed in 383 over a 31/2-year period. The reported incidence of sepsis and/or meningitis was 1.8%; for those less than 2 months of age, it was 5.0%. Epidemiologic investigation failed to disclose a consistent source of the Salmonella colonization for young infants. Treatment of meningitis with ampicillin sodium was frequently associated with relapse or clinical failure, while chloramphenicol or a chloramphenicol-ampicillin combination appeared to offer superior efficacy. Consideration should be given to antibiotics for the routine treatment of Salmonella gastroenteritis in infants less than 3 months of age.
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PMID:Salmonella sepsis in infancy. 731 4

A diabetic male patient presented with recurrent septicemia due to Salmonella panama. The nidus from which reinfections of the blood stream occurred was apparently localized in the epididymis. Cultures of semen grew Sal. panama while cultures of urine and stool showed no pathogens. This is the fifth reported case of salmonellosis involving epididymis and/or testicle, the first in a diabetic, and the first in which salmonella was found in cultures of semen. In this patient bacteriologic cure was obtained by use of trimethoprim-sulfamethoxazole obviating need for surgical extirpation of the infective focus as had been required in previously reported cases of salmonella epididymitis/orchitis.
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PMID:Salmonella epididymitis with recurrent septicemia in diabetic patient. 746 22

Four cases of extraintestinal salmonellosis caused by Salmonella enteritidis were described. Underlying diseases in the three patients were haematological neoplasms (2 splenectomized and 1 with massive leukemic infiltrations of the spleen) and in the fourth haemophilia B: only that patient had a prior symptomatic intestinal infection. Blood cultures for S.ent. were positive in all patients and additionally in that suffering from Hodgkin's disease urine, lymph node and stool cultures also showed S.ent. In the haemophiliac patient culture of suppurated hematoma was positive. All patients recovered from S. sepsis but three then died of their neoplastic diseases. The haemophiliac patient is in a good condition. Various disturbances in the immunological tests were observed.
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PMID:[Extraintestinal salmonellosis in patients with blood diseases caused by Salmonella enteritidis]. 747 35

The study of non-typhoidic salmonellosis in A. royer pediatric Hospital (Dakar) during a five year term (1985-1989) was realised on thirty five medical records. This pathology accounts for 0.4% of admissions and occurs mainly on children under 3 years old (83%) essentially with a pathologic background. The main clinical forms were septicemia (46%) and gastro-enteritis (31%). Purulent meningitidis represented 45% of all the localized forms. Only one case of asymptomatic carriage has been identified. The seventeen serotypes of Salmonella identified belong to eight serogroups. S. enteritidis and S. typhimurium represented 51% of the isolates. Susceptibility to antibiotics of these different serotypes were variable, the third generation cephalosporins and gentamycin having inhibited more than 80% of the strains. The mean duration of antibiotherapy was 21 days with a mortality rising to 17%. The association ampicilline-gentamycin although criticable, remains indication as first treatment because of the availability of these drugs.
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PMID:[Non typhoidic salmonellosis in the African pediatric population]. 749 22


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