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

Vibrio vulnificus is an extremely invasive gram-negative bacillus that causes bacteremia and shock. It should be suspected in any patient who is immunocompromised or has liver disease or hemochromatosis. Reduced gastric acidity may also increase the risk of infection if a patient presents with a history of ingesting raw shellfish (especially oysters) or trauma in brackish waters and skin lesions. Patients most commonly present with one of three clinical syndromes: primary septicemia, wound infection, or gastroenteritis. Treatment includes aggressive wound debridement, antibiotic therapy, and supportive care. Rapidly diagnosing and promptly initiating therapy are critical because V vulnificus infection is rapidly progressive and mortality approaches 100% if septic shock occurs.
West J Med 1991 Oct
PMID:Vibrio vulnificus. Hazard on the half shell. 177 90

Two fatal cases of haemophagocytic syndrome diagnosed on the basis of autopsy findings at the Queen Elizabeth Hospital, Barbados, are presented. They were both young patients, a male 20 years of age and a female 28 years of age, with common clinical features of severe constitutional symptoms, pharyngeal haemorrhages, pancytopenia, and fever. The female patient had elevated titres to herpes simplex virus indicative of recent infection as well as postmortem evidence of overwhelming mixed bacteria sepsis. In both cases, histopathological studies showed lymphoid depletion and histiocytes displaying haemophagocytosis.
West Indian Med J 1991 Dec
PMID:Haemophagocytic syndrome. 178

Cases of maternal deaths at Wesley Guild Hospital, Ilesa, Nigeria, from January 1977 to June 1988 were reviewed. The maternal mortality rate of 2.85 per 1000 births recorded is an improvement over earlier figures due at least in part to improved obstetric care services. Illegally induced abortion was the most significant cause of maternal deaths (32.7%). Other causes were sepsis (17.3%), obstetric haemorrhage (15.4%), ruptured uterus (9.6%) and anaemia (7.7%). The problems of illegal abortion, poor antenatal and delivery supervision and late referral of cases were implicated as aetiologic factors.
West Afr J Med
PMID:Trends in maternal deaths in Ilesa, Nigeria, 1977-1988. 206 88

Jaundice among Nigerian preterm infants under special care was studied to determine the incidence of clinical jaundice, the predisposing factors and outcome among those with significant hyperbilirubinaemia (SBR greater than or equal to 10mg/dl). The incidence of jaundice among 292 preterm infants over an 18-month period was 71.2%. The male: female ratio was 1:1.04. Of the 74 infants with serum bilirubin 10mg/dl or more, prematurity alone was the identified cause in 44 (59.5%), Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency and septicaemia were the only additional factors in 13 (17.6%) and 7 (9.5%) respectively, while multiple aetiological factors (prematurity, septicaemia and G-6-PD deficiency) were identified in six (8.1%) of the babies. Septicaemia was associated with higher mean bilirubin levels and the highest mortality. The two kernicteric infants in the study had septicaemia. Thus, the single most important cause of jaundice was prematurity. G-6-PD deficiency alone did not appear to increase the incidence and severity of hyperbilirubinaemia in this study. Septicaemia should be suspected and promptly treated in order to reduce mortality and risk of kernicterus among preterm infants with hyperbilirubinaemia.
West Afr J Med
PMID:Neonatal jaundice among Nigerian preterm infants. 208 1

The seroprevalence, clinical epidemiology, modes of transmission, clinical presentation in adults, pregnancy women and children, diagnosis, impact and control strategies of AIDS in Africa are covered in this review. HIV-1, the causative virus in AIDS, is epidemic in a central Africa belt from Gabon to the east coast, and from Uganda to Zimbabwe, with the highest prevalence in the lakes and highlands of Central Africa. HIV-2 causes a milder disease in Western Africa centered in Senegal. HIV infections occur primarily in young adult men aged 30-34, women aged 20-24, infants and children under 4, and a few girls. Transmission patterns vary widely depending on sexual customs in the ethnically diverse continent. Prevalence tends to be high in cities and among subgroups such as prostitutes, where promiscuity is restricted. Where female sexual permissiveness exists, seropositivity is high in women generally. Besides sexual behavior, risk factors for HIV in Africa also include uncircumcised man, oral contraception, STDs causing genital ulceration and Chlamydia infection. Transmission to neonates occurs, especially if the mother has advanced AIDS, but transmission by breast milk is uncertain. Transmission by blood transfusion is common because transfusion are up to 10 times as common in Africa as in the West, especially in obstetrics and pediatrics. Clinically, HIV infections present as herpes zoster in 95% of Africans, and commonly as slim disease: weakness, fever, chronic watery diarrhea and weight loss of unknown cause. Associated infection are candidiasis, cryptosporidiosis, isosporiasis, tuberculosis and salmonellosis. Other presenting symptoms are unusual sites of lymphadenopathy, cough and sepsis. Diagnosis can be made by the WHO clinical case definition, or be screening tests, which are now more reliable for African patients than formerly. In Africa, AIDS can cause destitution and disgrace for families, and will probable severely affect progress made national economies because of deaths of young productive adults. Strategies for control of HIV in Africa are outlined.
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PMID:AIDS in Africa. 218 39

Hereditary hemorrhagic telangiectasia is a rare, hereditary fibrovascular dysplasia. We report a case associated with hepatolithiasis. Hepatolithiasis, relatively common in East Asia, is rare in the West. The association of the two conditions has not been previously reported. In this case, vascular malformations in the liver gave rise to arteriovenous and arterioportal fistulas, causing arteriovenous shunting and protal hypertension, respectively. Abnormal blood flow is the proposed mechanism for the hepatic fibrosis and nodular regeneration. Hepatic fibrosis, by causing stenosis of large intrahepatic bile ducts, bile stasis, and secondary infection, is the hypothesized mechanism for calculus formation. Hepatolithiasis ultimately caused death from acute bacterial cholangitis and septicemia.
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PMID:Hepatolithiasis in hereditary hemorrhagic telangiectasia. 232 2

Sixty-eight patients at the University of Illinois, Cook County, and the West Side Veterans Administration hospitals underwent pelvic exenteration for advanced pelvic malignancies during the 15-year period from 1969 to 1984. Thirty-two had colorectal cancers, eleven cervical, seven bladder, and six vulvar; in twelve the cancers were in miscellaneous pelvic sites. Forty-five exenterations were done with intent to cure, and twenty-three for palliation of patients with bulky, necrotic tumors that had caused symptomatic fistulae, local sepsis, chronic bleeding, or severe localized pain. The total 30-day postoperative mortality was 4.4% (3/68). The 5-year survival rate of patients who underwent curative exenteration was 33% (median 27 months). Pelvic exenteration appears to be a feasible surgical procedure for a variety of advanced malignancies as well as for palliation of severely symptomatic patients.
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PMID:Pelvic exenteration. 241 58

This study records our experience with 40 infants who developed acute renal failure in a tropical environment over a period of 2 years. All the patients required intermittent peritoneal dialysis. Septicaemia (88%) and acute gastroenteritis (55%) constituted the leading causes of acute renal failure. Haemolytic uraemic syndrome was present in six (18%) patients. An elevated serum creatinine (85%), metabolic encephalopathy (75%), uncompensated metabolic acidosis (75%) and hyperkalaemia (48%) were the major indications for dialysis, while fluid overload was present in only 18% of the infants. Intermittent peritoneal dialysis was used in all the patients and was found to be effective. Procedural complications were minor and infrequently encountered. The clinical course and laboratory data consistent with haemolytic uraemic syndrome was observed in six patients, and acute tubular necrosis was the predominant renal lesion in the remainder. Mortality was 75%. The aetiology of acute renal failure in infants in the tropics differs significantly from that in the West, and even within a given country marked regional variations exist.
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PMID:Acute renal failure in infants in the tropics. 250 74

Colonic complications are rare in acute pancreatitis. Over the last 9 years at St. Mary's Hospital, London, UK, we have managed severe acute pancreatitis by intensive supportive therapy followed by sub-total pancreatic resection and/or debridement in those who fail to improve. Of the 22 patients who have undergone this form of surgery, nine were found to have colonic involvement in the form of either necrosis or perforation. In addition, one patient presenting at West Middlesex University Hospital, Isleworth, UK, had severe acute pancreatitis and almost total colonic necrosis as an unexpected finding at emergency laparotomy. These ten patients comprised seven men and three women of median age 59 years and with a median of four Ranson criteria. In seven patients, colonic involvement was discovered at the time of pancreatic surgery or laparotomy for pancreatitis and in the remainder it presented between 1 and 3 weeks later as either a faecal fistula (n = 2) or persistent abdominal sepsis (n = 1). The ascending colon was involved in one patient, the splenic flexure and descending colon in one, the transverse colon in three, the splenic flexure alone in four, and one patient had almost total colonic involvement. All patients underwent resection of the involved colon and exteriorization with either a proximal colostomy (n = 7) or ileostomy (n = 3) and a distal mucous fistula. Pathological examination of the resected colons revealed a spectrum of changes from pericolitis through to ischaemic necrosis suggesting at least two possible mechanisms. Six patients died from overwhelming sepsis between 1 day and 4 weeks (median 11 days) after colonic resection. Severe acute pancreatitis must be recognized as a cause of colonic ischaemia and necrosis; this complication is associated with a very poor prognosis despite surgical intervention.
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PMID:Colonic complications of severe acute pancreatitis. 265 21

Two patients with high voltage electrical injury involving the trunk are presented. Both injuries were complicated by visceral damage; and one patient died from sepsis secondary to bowel perforation. The rarity of this complication is examined in light of the pathophysiology of electrical injury; and its management is discussed with reference to previously published reports on this condition.
West Indian Med J 1989 Jun
PMID:Visceral complications of electrical burn injury. A report of two cases and review of the literature. 276 31


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