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

Group A beta haemolytic Streptococcus has been one of the most serious infections in the burn patients resulting in severe cellulitis and sepsis. Penicillin has been used ever since its introduction as prophylaxis against these conditions. Penicillin prophylaxis was used in our burn unit as well without any serious evaluation until December 1992. This prospective study was therefore, undertaken to evaluate the incidence of beta haemolytic Streptococcus infection in burn patients, and its clinical outcome over a period of 5 years in the absence of prophylaxis with penicillin. 14 of the 1213 burn patients admitted to the Al-Babtain Centre for Plastic Surgery and Burns from January 1993 to December 1997 had either colonization or infection with Streptococcus spp. Their mean age was 15 years (range 1 month to 52 years) and the mean burn surface area was 20% (range 5 to 90%). Streptococci were isolated from burn wounds in 10 patients, throat in 3 and blood culture in 1. Group A Streptococcus was found in 5, group C in 3 and group D in 6 patients. In all patients except one the organisms were isolated > or =72 h post burn. The infections were successfully controlled by antibiotic and no detrimental effect was observed either on wound healing or skin graft take. There was no mortality amongst these 14 patients. The study showed that only 1.1% of the burn patients in our unit acquired Streptococcus of which only one third comprised of group A. This study thus demonstrates that the practice of penicillin prophylaxis during the first five post burn days may not be of any value and therefore, deserves discontinuation in units where the incidence of this organism is minuscule.
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PMID:Beta-haemolytic Streptococcus infection in burns. 1032 9

The interesting association between delayed presentation of right-sided diaphragmatic hernia and neonatal Group B streptococcal infections occurs rarely and its pathogenesis is still obscure. Two preterm newborn infants with early onset of neonatal sepsis (one due to Group B Streptococcus) followed by recognition of right-sided diaphragmatic hernia on the 9th and 25th day of life are reported. In both cases the course of neonatal sepsis and pneumonia was complicated due to the appearance of right-sided pleural effusion and atelectasis. On serial chest roentgenograms right-sided bowel gas was noticed and the liver shadow became gradually elevated. Diagnosis was confirmed by ultrasonography and computed tomography. Suspicion of associated diaphragmatic hernia should be raised in neonatal streptococcal infection whenever subsequent progressive respiratory deterioration ensues, requiring mechanical ventilation after initial clinical improvement or in the presence of right-sided pleural effusion.
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PMID:[Early-onset neonatal sepsis and late-appearing diaphragmatic hernia]. 1043 50

Cellulitis is a common clinical entity. Hemorrhagic cellulitis is distinctly unusual and is most frequent in compromised hosts. In normal or near normal hosts, hemorrhagic cellulitis may rarely complicate gram-negative sepsis. Usually, hemorrhagic cellulitis occurs below the waist. The differential diagnosis includes invasive streptococcal infection, mixed aerobic and anaerobic infection, gram-negative sepsis, and gross gangrene. We present the first-known case of Escherichia coli chest-wall hemorrhagic cellulitis associated with a central line in a patient with renal failure.
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PMID:Escherichia coli chest-wall hemorrhagic cellulitis associated with central-line placement. 1108 Mar 27

Congenital lymphedema is a relatively rare disease caused by congenital abnormality of the lymphatic system. Although bacterial infection frequently causes complications with lymphedema, severe sepsis in congenital lymphedema of the genitalia has not yet been reported. We describe a patient with congenital penoscrotal lymphedema complicated by cellulitis, lymphangitis, and severe sepsis associated with a streptococcal infection. This case represents the importance of obtaining a detailed clinical history and physical findings.
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PMID:Congenital penoscrotal lymphedema complicated by sepsis associated with a streptococcal infection. 1113 88

Urinary tract infections are very common during pregnancy. Escherichia coli is the most common pathogen isolated from pregnant women. Ampicillin should not be used because of its high resistance to Escherichia coli. Pyelonephritis can cause morbidity and can be life-threatening to both mother and fetus. Second and third-generation cephalosporins are recommended for treatment, administered initially intravenously during hospitalization. Cultures and the study of virulence factors of uropathogenic Escherichia coli are recommended for the adequate management of pyelonephritis. The lower genital tract infection associated with pyelonephritis is responsible for the failure of antibiotic treatment. Asymptomatic bacteriuria can evolve into cystitis or pyelonephritis. All pregnant women should be routinely screened for bacteriuria using urine culture, and should be treated with nitrofurantoin, sulfixosazole or first-generation cephalosporins. Recurrent urinary infection should be treated with prophylactic antibiotics. Pregnant women who develop urinary tract infections with group B streptococcal infection should be treated with prophylactic antibiotics during labour to prevent neonatal sepsis. Preterm delivery is frequent. Evidence suggests that infection plays a role in the pathogenesis of preterm labour. Experimental models in pregnant mice support the theory that Escherichia coli propagated by the transplacental route, involving bacterial adhesins, induces preterm delivery, but this has not been demonstrated in humans. Ascending lower genital tract infections are the most probable cause of preterm delivery, but this remains to be proved.
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PMID:Urinary tract infections in pregnancy. 1114 47

Group B streptococcus is a possible cause of chorioamnionitis, endometritis and urinary tract infections in pregnant woman. Maternal risk factors and the vertical transmission of GBS and neonatal GBS infection occur through the following fever during labor, the rupturing of membranes more than 18 hours before delivery, prematurity and chorioamnionitis. GBS can induce early-onset neonatal disease (sepsis, meningitis or pneumonia) during the first week of life and late-onset neonatal infection (leptomeningitis) within the first 12 weeks of life. Numerous strategies for preventing neonatal group B streptococcal infection were investigated: 1) the treatment of GBS-colonized women during the third trimester of pregnancy did not prove to be effective because it does not reduce maternal colonizzation rates at delivery; 2) the neonatal universal post-partum prophylaxis with penicillin G was ineffective and increased neonatal mortality due to penicillin-resistant bacterial infection; 3) the intrapartum maternal chemoprophylaxis with penicillin G or ampicillin in GBS-colonized women, in women with risk factors, or in women with both GBS colonization and risk factors. The latter strategy proved to be the most effective because it reduces the risk of early-onset GBS infection by 75% and 95% when associated with post-neonatal prophylaxis. To date, there are no guidelines on the management of the asymptomatic neonate whose mothers have been treated with chemopropylaxis intra-partum.
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PMID:[Prophylaxis of group B beta-hemolytic streptococcal infections]. 1142 3

Perinatal group B streptococcal infection has been the subject of numerous studies and despite guidelines established during the last decade remains a frequent disease with high mortality. The basic aim of the guidelines is to screen for Streptococcus agalactiae during the antepartum period in order to institute antibiotic therapy during delivery. A critical review of the literature highlights the real impact and adverse effect of these guidelines: difficult application (only two-thirds of all maternity units have a protocol and compliance is only 75%), maternal risks of antibiotic therapy (especially the emergence of resistant Gram negative bacteria), fetal risks (accentuation of neonatal sepsis with resistant strains, retarded neonatal infections, frequent use of antibiotics with a broader spectrum, higher frequency of nosocomial sepsis).
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PMID:[Neonatal bacterial infection by maternal-fetal contamination: for a change in approach? 1. Detection of Streptococcus agalactiae infection: methods and evaluation of results]. 1188 20

A 21-year-old male patient with non-Hodgkin's lymphoma (diffuse large T-cell type, clinical stage IV) received allogeneic bone marrow transplantation (BMT) from a partially HLA-mismatched unrelated donor in July 1998 and achieved complete remission. Thereafter, he suffered from chronic graft-versus-host disease (GVHD) and was continuously administered immunosuppressive drugs for a long time. Two years after the BMT, he complained of severe pain in the right knee, which was swollen, and was diagnosed as having pneumococcal purulent genual arthritis. He underwent arthroscopic synovectomy and was administered systemic and intra-articular antibiotics, leading to a gradual improvement. Streptococcal infections are often seen in patients in the late phase after allogeneic BMT because of immunodeficiency associated with chronic GVHD and hyposplenism. Most streptococcal infections are respiratory tract infections and septicemia, and there have been very few reports on cases of purulent genual arthritis. Administration of prophylactic antibiotics and control of chronic GVHD, which is a risk factor of pneumococcal infection, seem to be important to prevent purulent genual arthritis.
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PMID:Pneumococcal purulent genual arthritis after allogeneic bone marrow transplantation. 1202 38

A 20-year-old male was admitted to our hospital with the chief complaints of high fever and pain around his right hip joint. He had his right knee injured with a slight abrasion three weeks before. The diagnosis of suppurative lymphadenitis of inguen was made, and intravenous cefotiam was started. Despite these treatments his fever continued, general edema and dry cough appeared. Arterial blood gas showed severe hypoxia and chest X ray revealed marked cardiomegaly associated with ground-glass opacity over bilateral lower pulmonary fields. Slight renal insufficiency was also observed. On the fifth hospital day, the culture specimens of both blood and pus from the abrasion on admission yielded Streptococcus pyogenes. His condition was diagnosed as severe group A Streptococcus infection, then antibiotics were switched to intravenous administration of high dose aminobenzyl penicillin and clindamycin in combination with protease inhibitor, urinastatin. After these treatments, his condition improved and he was discharged from the hospital after one month. Group A Streptococcus may cause uncommon but life-threatening infection such as septicemia. Early recognition of the disease and prompt initiation of appropriate treatment may lead to successful outcome.
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PMID:[A case of bacteremic group A streptococcus infection with organ dysfunction following a minor skin abrasion]. 1250 80

A case of hydrocele infection secondary to a cutaneous b-hemolytic group A streptococcal infection is described in a renal transplant recipient. Sepsis and renal failure occurred in the setting of this severe, life-threatening infection. This case represents the first description of a group A streptococcal hydrocele infection in an adult. This type of infection can progress rapidly to sepsis and its attendant complications, especially in an immunocompromised patient. Early diagnosis and treatment is crucial in order to optimize the outcome.
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PMID:Group A streptococcal hydrocele infection and sepsis in a renal transplant recipient. 1262 58


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