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

Twenty cases of children with Sclerema observed at a Pediatric Service during five years are presented. Their clinical and laboratory traits are integrated in a dermatosis appearing after various and usually serious complications. In the children observed the most frequent finding was represented by sepsis, some of them with disseminated intravascular coagulation syndrome, diarrhoea with dehydration. The therapy applied, fundamentally was based on parenteral solutions, antibiotics and corticoids, was directed by those diseases and not by the presence of sclerema, which however appeared influenced by the supply of the latterly mentioned medicaments. Microscopic disturbances are discussed too, and a reference is made to the incriminabea pathogenic mechanisms.
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PMID:[Sclerema (clinical review apropos of 20 cases)]. 124 Oct 81

Toxic epidermal necrolysis (TEN) is a life-threatening bullous dermatosis characterized by the sudden onset of full-thickness epidermal necrosis. TEN is a disease of both children and adults, but TEN in early infancy is a rare event; only two well-documented cases in infants less than 6 months of age have been reported. We report a third case of a 6-week-old infant with Escherichia coli sepsis who received ampicillin and other antibiotics and subsequently developed TEN. Despite the withdrawal of ampicillin and aggressive systemic and wound care, the infant died. The infants in the other two reported cases also died, which suggests that TEN in early infancy has an extremely poor prognosis.
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PMID:Toxic epidermal necrolysis in early infancy. 151 1

558 episodes of bacteremia were detected in our medical center during a 2-year period. 17 of them (3%) were of cutaneous origin. 12 cases were community-acquired and 5 were hospital-acquired. The patients median age was of 65 years. 15 patients had a baseline disease, the most frequent being diabetes mellitus and neoplastic disease. The most common bacteria isolated were group A beta-hemolytic Streptococcus, Staphylococcus aureus, and Escherichia coli; 2 patients had multibacterial episodes. Decubitus ulcer and cellulitis were the most frequently associated skin disease. Global mortality was of 47% and was sepsis related in 29% of the cases. Death prognosis factors were old age, diabetes mellitus, gram-negative causal bacteria, nonappropriate antibiotic therapy, low index of clinical suspicion.
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PMID:[Bacteremia of cutaneous origin]. 210 66

A 55-year-old woman developed Sweet's syndrome (acute febrile neutrophilic dermatosis, AFND) 5 years after a diagnosis of chronic lymphocytic leukemia (CLL). Two months later she developed a scirrhous carcinoma of the breast. The patient died 7 months later from sepsis. To our knowledge, this is the first case of an association among a cancer of the breast, CLL and Sweet's syndrome.
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PMID:Sweet's syndrome and chronic lymphocytic leukemia associated with scirrhous breast cancer. A case report. 216 1

Epidermolysis bullosa (EB) is a rare hereditary skin disease of infancy that can involve the mucous membranes of the oral cavity. Laryngotracheal involvement is rare. The disease is characterized by bullae formation in response to minor trauma. There are at least 18 described types of EB, however, there are 3 basic categories. These are simplex (with disruption above the basement membrane), dystrophic (in which disruption is below the basement membrane), and junctional (in which the split is within the lamina lucida). The prognosis of the different types ranges from early death usually secondary to overwhelming sepsis, to long term survivals with lack of growth retardation or significant dystrophic scarring. Presently, survival appears to be the only reliable criteria for distinguishing the benign and lethal forms of EB. Airway obstruction secondary to laryngotracheal involvement should be considered in any child with epidermolysis bullosa presented with symptoms of respiratory distress. Because there are few predictive prognostic indicators in the neonatal period, tracheotomy should be considered early in an effort to prevent further laryngeal injury from intubation, in those patients that will survive.
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PMID:Laryngotracheal involvement in epidermolysis bullosa. 276

Scleromyxedema is a rare fibromucinous connective tissue disorder characterized by papular skin lesions associated with sclerosis and a serum monoclonal gammopathy. Little is known about either the natural history or the systemic manifestations of this disease. We reviewed the medical records of 19 patients with biopsy-proven scleromyxedema seen from 1950 to 1985 for evidence of systemic disease. There were 10 males and 9 females with a median age at diagnosis of 53 years. Monoclonal gammopathy was present in 13 patients. Eight patients complained of dysphagia; 3 had proximal esophageal dysfunction and 1 had total esophageal aperistalsis on barium swallow. Proximal muscle weakness was noted in 5, with an inflammatory myopathy in 3. Six patients complained of dyspnea on exertion. Of these, 5 had reduced diffusing capacity, 3 had reduced volumes, and 2 developed cor pulmonale. Pathologic changes characteristic of "scleroderma kidney" were demonstrated in 1 patient at postmortem. One patient had Raynaud's phenomenon and 2 had arthralgias/arthritis with noninflammatory synovial fluids. Although 8 of 12 patients treated with melphalan noted regression of their skin changes, no consistent improvement in the extracutaneous manifestations was demonstrated. Furthermore, 2 patients died of sepsis related to melphalan-induced myelosuppression, and 4 developed hematological malignancies following melphalan therapy. In conclusion, systemic manifestations in scleromyxedema are more prevalent than previously recognized, and can resemble those of scleroderma. Significant toxicity occurred with the use of alkylating agents in these patients, with treatment-related complications developing in 45% of patients treated with melphalan. The lack of definitive data regarding the natural history of this disease complicates the question of optimal therapy, but the use of alkylating agents should be reserved for those patients with severe debilitating skin disease.
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PMID:Scleromyxedema: a scleroderma-like disorder with systemic manifestations. 333 81

Neutrophilic eccrine hidradenitis (NEH) is a recently described neutrophilic dermatosis associated with acute myelogenous leukemia (AML) and chemotherapy. This disorder is a distinct clinicopathologic entity separate from leukemid reactions and other neutrophilic dermatoses. We describe two cases in which plaques or nodules developed in the second week after initiation of induction chemotherapy for AML. The lesions regressed in 1 week and recurred in one case when induction chemotherapy was given a second time. Histologically, the findings were similar in each case. Neutrophils palisaded about and infiltrated the eccrine coil in which necrosis of secretory epithelium was present. Focal mucinous degeneration of the eccrine adipose tissue cuff was the only other significant alteration. No vasculitis was observed. Cultures and histologic preparations for pathogenic organisms were negative. Cytarabine was the chemotherapeutic agent used in all three cases. NEH most likely represents either an unusual response caused by cytarabine or a manifestation of AML. Recognition of NEH is important in order to exclude other neutrophilic dermatoses associated with AML, such as sepsis and leukemia cutis, which may appear clinically similar.
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PMID:Neutrophilic eccrine hidradenitis: a distinctive rash associated with cytarabine therapy and acute leukemia. 623 61

Zinc deficiency dermatitis is a recognized complication of prolonged total parenteral nutrition (TPN) in adults and children. Ten cases of a characteristic dermatosis developing in premature infants with hypozincemia while on long-term TPN are described. The infants presented a defined group of premature neonates who were born between 25 and 28 weeks' gestation with birth weights of less than 1,200 gm and who had received continuous prolonged TPN. The characteristic skin changes appeared on an average of 91 days after birth, with prominent and early involvement of the neck fold crease. Lesions also occurred on the cheeks, buttocks, and genitalia, but spared the extremities. In seven of the ten cases, the skin changes and low serum zinc levels developed 1 to 5 days after an episode of bacterial sepsis or signs of physiologic stress.
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PMID:Zinc deficiency dermatosis in premature infants receiving prolonged parenteral alimentation. 679 46

Pemphigus is frequently a fatal skin disease. The cause of death and the events leading to it were investigated by examining patient records and autopsy data of thirteen patients who died as a result of this disease at the UCLA Hospital between 1965 and 1980. The diagnosis was confirmed histologically and/or by immunofluorescent studies of the skin and serum. Infection was the most frequent cause of death, and septicemia was found in nine of thirteen cases. The most commonly found organism was Staphylococcus aureus. The skin was usually the source of infection. Nine patients had pneumonia on chest x-ray and autopsy examination. Most patients had low levels of serum proteins and serum albumin. Since the patients were on long-term high doses of corticosteroids, the signs and symptoms of inflammation were often masked. This study demonstrated that for this reason, long-term corticosteroid therapy is one of the significant factors contributing to the death of these patients. A cautious and judicious use of steroids is suggested.
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PMID:Death in pemphigus. 713 Apr 83

A characteristic intermittent neutrophilic dermatosis, associated with polyarthritis, tenosynovitis, malaise, fever, and cryoglobulinemia, occurs in 20% of patients who undergo ileojejunal bypass surgery for the treatment of morbid obesity. The clinical syndrome may mimic gonococcal sepsis. The histologic changes in the skin are those of Sweet's syndrome. The syndrome remits spontaneously in most cases, but it may recur intermittently over a period of years. Treatment with low-dose steroids, tetracycline, or metronidazole suppresses symptoms in most cases, and restoration of normal bowel anatomy is curative. Skin testing with Streptococcus pyogenes antigen causes an excerbation of symptoms, or may provoke the entire syndrome de novo. Bacterial peptidoglycans, especially those of group A streptococci, produce similar arthritis and skin lesions in animal models. Peptidoglycans from numerous intestinal bacteria share common structural and antigenic features with S. pyrogenes peptidoglycan and are suggested as causative of the toxic and immunologic features of this syndrome.
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PMID:The bowel bypass syndrome: a response to bacterial peptidoglycans. 740 Apr 4


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