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

Laminar air flow isolation and decontamination procedures were evaluated in a prospective randomized study in patients with aplastic anemia or acute leukemia undergoing marrow transplantation from HLA-matched siblings. Patients transplanted in the laminar air flow group had significantly less septicemia and major local infections than did patients in the control group. Nineteen of 46 laminar air flow patients and six of 44 control patients are alive at present. In patients with aplastic anemia the survival was 13 of 17 in the laminar air flow group compared with four of 17 in the control group. In patients with acute leukemia the survival was six of 29 in the laminar air flow group versus two of 27 in the control group. These differences were not statistically significant. Death in both the laminar air flow and control groups was predominantly due to interstitial pneumonitis or recurrent leukemia, which were unaffected by isolation and decontamination.
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PMID:Protective environment for marrow transplant recipients: a prospective study. 3 Nov 23

Necrotizing angiitis or vasculitis exhibits a wide clinical spectrum characterized by many different cutaneous manifestations. Diagnosis must be confirmed by histopathology. We studied in retrospect 25 patients whose conditions had been diagnosed by skin biopsy. Histologic examination revealed infiltration by polynuclear cells and fibrinoid necrosis of the walls of the blood vessels in the skin. The great variety of clinical manifestations and etiologies stands out in a review of the records of these patients. Necrotizing angiitis has been found associated with mixed cryoglobulinemia; administration of drugs, milliary tuberculosis, bacterial meningitis, rickettsiosis, staphylococcal sepsis, pharyngotonsillitis, and rheumatoid arthritis. Necrotizing angiitis is a group of diseases with a great variety of clinical manifestations, ranging from benign to fatal. The various entities described to date have been more like different clinical forms of the same disease that distinct conditions. In cases of necrotizing angiitis caused by basically immunological mechanisms, the walls of the blood vessels may be impaired in varying diffuse degrees. The prognosis of the disease depends on the intensity of the inflammation and its repercussions on the parenchymas of different organs. The kidney is the most susceptible organ in this case. Treatment should be directed toward the avoidance of predisposing and etiologic factors, detection of the immunological reaction, requiring careful and individual attention in every case.
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PMID:[Necrotizing angiitis of small vessels. A clinical study of 25 patients with skin biopsy (author's transl)]. 3 57

Postsplenectomy, 41 patients previously treated for Hodgkin's disease were given pneumococcal vaccine, and type-specific antibody levels were measured before and after immunization. Postimmunization antibody levels in patients with Hodgkin's disease were significantly lower than those in normal control subjects for 10 of the 12 serotypes measured. Mean postimmunization antibody level for patients (587 +/- 427 ng of antibody nitrogen/mL) was much lower than that for control subjects (1787 +/- 694). Antibody levels tended to increase with time from therapy for Hodgkin's disease, and several patients who had not received therapy for more than 3 years had normal responses to immunization. Despite vaccination, one patient developed pneumococcal meningitis and another, pneumococcal bacteremia. Both infected patients had low postimmunization mean antibody levels (282 and 137 ng/mL, respectively). Postsplenectomy sepsis in patients with Hodgkin's disease is related to a humoral immune deficiency probably induced by radiation and chemotherapy, and this immune deficiency persists for several years.
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PMID:Response of patients with Hodgkin's disease to pneumococcal vaccine. 3 21

The occurrence of septic complications after burns depends first of all from the surface extension of thermic injury and the age of patient. The expansion of the indication for primary excision doesn't change a great deal the frequence of septic occurences. Insufficient excision and skin covering to the other hand can be the source of lethal infection. Secondary skin grafting is an important mean for eradicating obvious sepsis. From among the parenchymal localisations the septic lung complications take the first place, which fact can be in connection with the thermic injury of the respiratory tract.
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PMID:[Septic complications following thermic injuries (author's transl)]. 3 12

During the last 5 years 22 patients have been treated at our hospital for staghorn calculi and neurogenic bladder. In 17 patients an operation was done soon after discovery of the calculi, while 5 patients were followed non-operatively. The latter 5 patients had a rapid downhill course marked by sepsis and renal function deterioration and an operation was necessary in 4 of the 5 cases. Injudicious non-operative therapy only prolongs the relentless effects of staghorn calculi in patients with spinal cord pathology.
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PMID:Operative versus non-operative management of patients with staghorn calculi and neurogenic bladder. 3 47

Hairy cells from eight patients with hairy cell leukemia were evaluated with both light and transmission electron microscopy for their capacity to phagocytose zymosan, latex, staphylococcus aureus, and pseudomonas aeruginosa. In two patients, there was no phagocytosis of any of these substances; cells from three patients phagocytosed only latex; two, all except pseudomonas; and one, all 4 substances. Hairy cells became relatively smooth while in culture with staphylococcus, but no surface changes were noted during incubation with the other substances. Of the eight patients studied, one died of pseudomonas pneumonia and sepsis; pseudomonas was the only substance which her hairy cells did not phagocytose. The one patient whose hairy cells phagocytosed all 4 test substances developed a disseminated Mycobacterium intracellulare infection; culture of his hairy cells with this atypical myocbacterium showed no phagocytosis. Hairy cells have different phagocytic capabilities from patient to patient, and the evaluation of these capabilities in vitro might provide early identification of potential infectious complications.
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PMID:Hairy cell leukemia: differences in phagocytic capacity of cells in vitro. 3 38

A 58-year-old man who survived an episode of fulminant pneumococcal septicemia with disseminated intravascular coagulation had undergone splenectomy 23 years previously. In the literature there are 25 reported cases of fulminant septicemia and disseminated intravascular coagulation associated with asplenia in adults (excluding cases in which corticosteroid or immunosuppressive therapy was given). The pneumococcus was responsible for all of these cases as well. The mortality in this series was more than 90%, and death occurred within 24 hours of presentation at hospital in almost 70% of the fatal cases and was associated with high-density bacteremia and adrenal hemorrhage. Gram-staining of the buffy coat of the peripheral blood or the exudate from purpuric skin lesions was carried out in only 6 of the 26 cases but yielded positive results in all but 1. It is concluded that a diagnosis of septicemia in asplenic adults can be established within a short time of presentation on the basis of statistical probability and the results of Gram-staining of the peripheral blood and exudate from the skin lesions. Prevention appears to be the cornerstone of management because of the variable interval from splenectomy to the onset of the syndrome and the high mortality.
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PMID:The syndrome of pneumococcemia, disseminated intravascular coagulation and asplenia. 3 2

Granulocyte transfusion is becoming widely used in the treatment of infections in granulocytopenic patients. Several techniques are available for granulocyte collection. Some involve centrifugation of the whole blood and one removes granulocytes from whole blood by reversible adhesion to nylon fibers. The risks to the donor from leukapheresis do not appear to be greater than from whole blood donation. Granulocytes collected by centrifuge techniques function normally in vitro and have normal intravascular recovery and disappearance following transfusion. Granulocytes collected by filtration leukapheresis function almost normally in vitro but have a reduced intravascular recovery and abnormal kinetics as they leave the circulation. The role of leukocyte typing and compatibility testing for granulocyte transfusion is controversial. When the recipient has circulating antibody against donor leukocytes, transfused leukocytes do not circulate or migrate to sites of infection but are sequestered in the liver and spleen. Clinical studies have not defined whether patients benefit equally well clinically from transfusion of compatible or incompatible granulocytes. Initial reports of clinical trials of granulocyte transfusion were promising. However, similar patients who did not receive granulocytes were not studied. Most subsequent controlled trials showed a clear benefit from granulocyte transfusion while others did not. Differences in antibiotic therapy, chemotherapy, use of laminar flow rooms, and grouping of patients make it difficult to compare these clinical trials. Some, but not all, infected granulocytopenic patients benefit from transfusion. Granulocyte transfusions improve survival of granulocytopenic patients with gram negative sepsis and prolonged bone marrow aplasia. Studies are now attempting to identify other patients who should receive granulocytes, the optimum dose and schedule of transfusions, the optimum time to begin transfusion, and the value, if any, of prophylactic transfusions.
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PMID:Leukapheresis and granulocyte transfusion. 3 51

Rabbits received intravenous injections of bacteria or fungi, and a comparison was made of the abilities of broth cultures, plating after dilution either in saline solution or in distilled water containing Triton X-100, and buffy coat examinations to detect the organisms in heart blood. The most sensitive method was broth culture. By microscopy or subculture of buffy coat cells prepared by centrifugation of blood in microhematocrit tubes, organisms were rapidly and regularly detected when their viable counts increased to 300--1,000/ml as detected by plating. By micromodification, buffy coat examination is technically easy to perform, and the method is only slightly less sensitive than when a larger amount of blood is used. Thus, it would be ideal for rapid provisional diagnosis of sepsis in patients, e.g., neonates, when the use of only a small blood sample is preferred.
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PMID:Detection of experimental bacteremia and fungemia by examination of buffy coat prepared by a micromethod. 3 62

A nineteen-month-old child presented with a febrile illness, skin rash, painful swelling of the joints, lymphadenopathy and hepatosplenomegaly. Pseudomonas was cultured from the blood during life and, subsequently, at autopsy. Autopsy revealed a generalized panarteritis involving the coronary, retroperitoneal and pulmonary arteries with thickening of arterial walls and narrowing of the lumina. Thrombi and foci of necrosis and infarcts were found in many organs. Numerous bacilli were present in fresh lesions, but not in the organizing lesions. Periodic acid-Schiff-positive deposits were found in occasional macrophages, in walls of affected vessels, in the marginal sinuses of lymph nodes and diffusely in epicardial and retroperitoneal adipose tissue. The findings suggest that some or even all cases of Kawasaki's disease and infantile polyarteritis nodosa may be caused by Pseudomonas sepsis. It is also suggested that the vasculitis and paucity of inflammatory reaction in many cases of Pseudomonas sepsis might be related to the fact that many strains of Pseudomonas produce high-molecular-weight levan (or another polysaccharide). This compound is known to inhibit the inflammatory reaction and to increase bacterial pathogenicity.
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PMID:Kawasaki's disease and infantile polyarteritis nodosa: is Pseudomonas infection responsible? Report of a case. 3 42


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