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Query: UMLS:C0036690 (
sepsis
)
59,461
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
In a prospective study at a hospital for infectious diseases 151 patients, 110 with proved and 41 with probable
septicemia
, were analysed. Clinical, laboratory, therapeutic data and prognostic experiences, partly from a follow-up study, are described. Secondary manifestations, mostly from skin, mucous membranes, nervous system and lungs, were present in 72%. They were more often caused by gram-positive cocci than by gram-negative baccilli and in some cases not revealed until autopsy. Lesions in the nervous system were most often caused by strepto- or penumococci or Haemophilus influenzae. In 2 splenectomized patients with extensive hemorrhages, pneumococci were isolated. Subacute courses were rare even in alpha-
streptococcal infection
and its "classical signs" were never observed. Shock and thrombocytopenia suggesting disseminated intravascular coagulation occurred together in 11%, and in one-third in the lethal cases. Gram-positive bacteria were often involved. Leukocytosis was absent in 53 patients; 20 were alcohol or narcotic drug abusers, and 7 died. ECG changes were registered in 33%. Initial antibiotic treatment was applied according to a fixed schedule, with cure in 61% on this first treatment, and especially so in infections with gram-positive cocci. During the initial hospital stay 20% died from uncontrolled infection. All had underlying diseases or factors, often major causes of death. The infection was regarded as hospital-acquired in 40% among the lethal cases. During a one-year follow-up period 3 patients died from a new
septicemia
and 10 from their underlying disease.
...
PMID:A prospective study on septicemia. II. Clinical manifestations and complications, results of antimicrobial treatment and report of a follow-up study. 743 19
Before the introduction of antibiotics, serious infections caused by Streptococcus pyogenes (Lancefield Group A streptococci) were common. Before World War II, this bacterium was responsible for as many as 50% of postpartum deaths and was the major cause of death in patients with burns. Also common were the sequelae of streptococcal infections-rheumatic fever and post-streptococcal glomerulonephritis. With the use of penicillin, however, Streptococcus pyogenes was believed to be virtually eliminated as a pathogen. The organism was consigned to the history books, but not for long. In the mid-1980s, focal resurgences of rheumatic fever began to be reported from different areas in the USA, such as Salt Lake City, Utah. In such communities, where increases in cases of rheumatic fever had been reported, the serotypes M-1, 3, 5, 6 and 18 were isolated which, on culture, produced characteristic mucoid colonies. At the same time, reports of increases in invasive streptococcal disease began to surface in both the USA and Europe. Two syndromes were described; invasive
streptococcal infection
, occurring in previously healthy children and adults, commonly associated with septicaemia resulting from a deep focus of infection such as bone or lung; and streptococcal toxic shock syndrome, involving a cutaneous focus, accompanied by necrotizing or bullous soft tissue changes.
Septicaemia
is rare in streptococcal toxic shock syndrome, but the most characteristic feature is one of rapidly progressing multi-organ failure. A high proportion of the strains of Streptococcus pyogenes associated with this condition are serotype M-1, and fatality rates approaching 50% have been reported.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Invasive streptococci. 772 68
Group B
streptococcal infection
often causes perinatal
sepsis
. Early diagnosis is based on a high index of suspicion and laboratory tests. Proposed interventions targeted at the antepartum, intrapartum, and postpartum periods have met with limited success. Screening has not been widely adopted.
...
PMID:Group B streptococcus. Is it time for a screening program? 775 13
Group B streptococci are the major cause of
sepsis
and fatal shock in neonates in the United States. Although a number of clinical features have been associated with enhanced severity of disease, the role of soluble immune complex formation in group B
streptococcal infection
has not been evaluated. We determined the frequency with which circulating immune complexes occurred in 16 infants with nonfatal type III, group B streptococcal meningitis, using an immunoglobulin-specific C1q enzyme immunoassay. Ten healthy, age-matched infants served as a control group. Elevated levels of immunoglobulin M (IgM)-containing immune complexes were present in the sera of four (25%) patients with group B streptococcal meningitis. Group B antigen was detected in precipitated IgM immune complexes from each of these four infants by competitive enzyme-linked immunosorbent assay. In addition, IgG-containing immune complexes were present in 56% of sick and 60% of control infants. Group B antigen was demonstrated in the serum of a sick neonate containing only IgG immune complexes but not in controls. Our findings indicate that a subset of infants with type III, group B streptococcal meningitis develop IgM immune complexes containing group B-specific antigen, and these may persist for up to 3 months in some patients.
...
PMID:Demonstration of circulating group B streptococcal immune complexes in neonates with meningitis. 781 22
Purpura fulminans is a rare syndrome of progressive hemorrhagic necrosis of the skin that may present as a dermatologic emergency. It most commonly affects children during the convalescent phase of a
streptococcal infection
or a viral exanthem. In adults, it may be associated with
sepsis
or acquired causes. Its pathogenesis has challenged physicians for decades. It has been discovered that purpura fulminans is almost always associated with disseminated intravascular coagulation and can occur in subjects with inherited or acquired deficiencies of the protein C anticoagulant pathway. Patients with liver compromise may also be potential candidates for coagulopathies secondary to hepatic dysfunction and impaired protein synthesis. It is widely recognized that individuals who consume alcohol on a long-term basis may develop severe hepatotoxicity from ingestion of therapeutic doses of acetaminophen (500 to 1000 mg every 4 to 6 hours). We have observed a patient with chronic alcoholism in whom hepatotoxicity and purpura fulminans developed secondary to the ingestion of acetaminophen.
...
PMID:Acquired purpura fulminans induced by alcohol and acetaminophen. Successful treatment with heparin and vitamin K. 821 90
An 88 year old woman with streptococcal pneumonia developed purulent pericarditis and cardiac tamponade despite treatment with antibiotics. Percutaneous pericardial drainage was effected with a 6 French pigtail catheter inserted via the subxyphoid approach. Catheter drainage was continued for 7 days in conjunction with systemic antibiotics. Catheter patency was maintained with antibiotic lavage. Immediate hemodynamic improvement followed the initial pericardial drainage. Fever, leukocytosis, and
sepsis
resolved during the course of therapy. The patient recovered fully from the closed space bacterial infection without additional surgical drainage. There has been no recurrence of
streptococcal infection
and no echocardiographic evidence of recurrent pericardial effusion after 3 months of follow-up. Indwelling catheter drainage combined with antibiotics may be an effective substitute for surgical drainage in the treatment of streptococcal pericarditis.
...
PMID:Catheter lavage and drainage of pneumococcal pericarditis. 822 57
A new type of fulminant group A
streptococcal infection
in obstetric patients is described. The illness occurs in late stage of pregnancy, and is preceded by an episode of upper respiratory tract infection. This is followed by sudden onset of
septicemia
, subsequent hematogenous infection of the myometrium by the bacteria, and development of acute purulent myometritis. Shock and multiorgan failure ensue rapidly. Prognosis of both the mother and fetus is very poor, as recognition of this serious condition is difficult until the late stage of the disease. This type of infection is entirely different from classical puerperal sepsis in that the illness starts before delivery, and that there was no evidence of ascending bacterial infections of the birth canal, such as acute endometritis or chorioamnionitis, in affected mothers. The underlying mechanism for this serious infection remains unknown.
...
PMID:A new type of fulminant group A streptococcal infection in obstetric patients: report of two cases. 910 54
This is a review of the symptoms and signs of children with malignant diseases and
septicemia
due to viridans streptococci, treated during a 6-year-period (1990-1995) in the Departments of Pediatrics or Pediatric Surgery, University of Leipzig. All 11 children suffered from leukemia. Streptococcus mitis was the most frequently isolated streptococcal species. All patients had fever and malaise, in most cases we could find inflammatory signs of the respiratory tract. In two children we saw a severe course of the disease, one child had symptoms and signs of ARDS, the other died on septicemic shock. All 11 patients had neutropenia and a central venous line, 10 of them were treated by cytarabine before the
streptococcal infection
was diagnosed. Like others we could note during the last years an increase of systemic infections due to viridans streptococci in neutropenic patients with malignant diseases. Possibly there is an association between
streptococcal infection
and cytarabine therapy. The empiric antibiotic therapy in neutropenic patients with malignant diseases should cover also streptococcal infections.
...
PMID:[Infection caused by viridans streptococci in children with malignant hematologic diseases]. 944 21
Group B
streptococcal infection
is the most common cause of neonatal
sepsis
and is responsible for significant neonatal morbidity and mortality. Group B streptococcus is also the causative agent in 50,000 maternal infections per year. Approximately 30% of women have asymptomatic group B streptococcal colonization at some time during pregnancy, but the neonatal attack rate is only about 2 per 1,000 deliveries. Maternal and neonatal risk factors contribute to the rates of vertical transmission and symptomatic neonatal disease. Options that have been investigated for prevention of neonatal group B streptococcal disease include identification of at-risk pregnancies as well as antenatal, intrapartum, and neonatal treatment. The intrapartum treatment of women at risk for vertical transmission of group B streptococcus to their neonates unequivocally has been shown to decrease the rate of neonatal colonization. Practitioners should implement one of two strategies that incorporate intrapartum prophylaxis for prevention of perinatal group B disease.
...
PMID:Group B streptococcal infections. 973 91
Of 74,920 babies live born in Oxford between 1985 and 1996, 41 (0.5 per 1000 95% CI 0.4-0.7) developed definite, culture confirmed, early onset (< 48 hours) group B
streptococcal infection
and 32 (0.4 per 1000 95% CI 0.3-0.6) developed probable infection (
sepsis
plus colonisation). There was no significant variation in incidence with time. The mortality from definite infection was 19.5%, and from probable infection 6%. These data suggest that the incidence of group B
streptococcal infection
in Oxford is considerably lower than that reported in the USA.
...
PMID:Early onset group B streptococcal neonatal infection in Oxford 1985-96. 982 44
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