Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Deep visceral fungus infections, induced by occasional pathogens, have caused a new class of diseases, and occupy a more and more important place among the complications due to immunosuppressive agents. The experience of the Mycology Unit of the Pasteur Institute, where recent techniques of mycological and immunological diagnosis of these fungus infections are used, is reported here. 24 patients submitted to corticosteroids and other immunosuppressive treatments, including 6 renal transplants and one liver transplant, developed deep visceral infection with septicemia due to Candida, in a series of 106 cases of deep candidiasis due to massive antibiotic treatment diagnosed over the last few years. The mycological, immunological and therapeutic data obtained after treatment with amphotericin B and 5-fluorocytosine are reported here. 8 cases of meningeal, pulmonary and bony and cutaneous cryptococcosis, occurring after corticotherapy (6 cases), radiotherapy (1 case) and renal transplantation (one case), are presented together with the favourable results (6 cures out of 8) obtained with amphotericin B and 5-fluorocytosine, eight alone or in association. The authors also report 2 cases of aspergillosis, one in the lung, occurring in a case of renal transplantation who was given, at an early stage, amphotericin B and 5-fluorocytosine, thanks to rapid laboratory diagnosis, and another case in a heart transplant with pulmonary and cerebral localisations from which the patient died. The literature on these fungus infections, together with the mucormycoses, nocardioses and other fungus and antinomycosal complications are reported, together with parasitic infections the severity of which is emphasized in renal transplants, in particular P. carinii pneumonia, toxoplasmosis, strongyloidiasis and other parasitic diseases.
 ...
PMID:[Fungal and parasitic infections during immunosupressive treatment (author's transl)]. 77 10

In this project, we examined the spectrum of AIDS-related conditions and variations in associated inpatient mortality for AIDS patients treated in a national sample of hospitals. We identified 10,538 adult discharges with a diagnosis indicating AIDS from 258 hospitals from a national sample of 438 acute-care hospitals with 6 million discharges in 1986-1987. Opportunistic and other infections occurred in 55.9 and 37.9%, respectively, of AIDS discharges, and inpatient fatality rates varied considerably depending on complication type(s) and comorbidities. Clinical conditions were more important predictors of inpatient death than demographic or treatment site characteristics. Among opportunistic infections, odds of inpatient death were significantly increased for progressive multifocal leukoencephalopathy (odds ratio [OR] = 2.8), Pneumocystis carinii pneumonia (OR = 2.4), cryptococcosis (OR = 1.6), atypical mycobacterial infections (OR = 1.6), and toxoplasmosis (OR = 1.3). Odds of inpatient death were also significantly increased by non-AIDS-defining infections causing septicemia (OR = 3.1) or CNS involvement (OR = 1.6) or pulmonary involvement (OR = 1.5). After controlling for clinical conditions, significant differences in odds of death persisted across regions, age, and ethnic groups. Increases in hospitals' AIDS treatment experience were associated with a significant decrease in odds of inpatient death. These analyses provide a national perspective on the diversity of AIDS-related clinical conditions and their relative effects on inpatient mortality.
 ...
PMID:Variations in inpatient mortality for AIDS in a national sample of hospitals. 145 27

A 24-year-old woman with acquired immunodeficiency syndrome was admitted with septic fever of unknown origin and a 2-week history of diarrhea. Clinical diagnostic procedures did not reveal the cause of sepsis. Broad-spectrum antibiotics and intensive symptomatic therapy could not prevent progressive deterioration. The patient developed septic shock and consumptive coagulopathy and died 6 days after admission. Autopsy revealed disseminated infection with toxoplasma gondii and multiple organ manifestations. We conclude that disseminated toxoplasmosis should be considered in AIDS patients with septic disease of unknown origin. Extremely elevated lactate dehydrogenase may suggest disseminated toxoplasma gondii infection. New procedures such as polymerase chain reaction for detection of toxoplasmosis may be helpful diagnostic tools.
 ...
PMID:Disseminated toxoplasmosis with sepsis in AIDS. 146 32

Diagnostic findings were reviewed on 157 sick or dead gray foxes (Urocyon cinereoargenteus) from the southeastern United States examined during the period 1972 through 1989. Most foxes (n = 118) originated from Georgia; fewer animals were from Florida, Kentucky, Maryland, Mississippi, North Carolina, South Carolina, Tennessee, Virginia and West Virginia. Etiologic diagnoses included canine distemper (n = 125), congenital absence of guard hairs (n = 7), traumatic injuries (n = 7), rabies (n = 3), suspected toxicoses (n = 3), verminous pneumonia due to Paragonimus kellicotti (n = 1), bacterial septicemia secondary to Dracunculus insignis (n = 1), and tick paralysis (n = 1). Concurrent toxoplasmosis or toxoplasmosis or cryptosporidiosis was noted in six and three foxes with canine distemper, respectively. Only lesion diagnoses were attainable for three foxes, and six cases were classified as undetermined. Canine distemper was diagnosed in 78% of the foxes, was geographically widespread, was detected in 16 of 18 yr, and exhibited a seasonal pattern of occurrence. These facts indicate that canine distemper is more significant as a mortality factor for gray foxes than all other infectious and noninfectious diseases combined.
 ...
PMID:Diseases diagnosed in gray foxes (Urocyon cinereoargenteus) from the southeastern United States. 154 99

In the immunocompromised patient, even mild forms of any combination of headache, meningismus, altered mental status, or focal neurologic signs should initiate an evaluation for possible CNS infection. The limited signs and symptoms of acute CNS infection are not due to specific organisms but to pathologic changes at the neuroanatomic site of infection. The initial clinical history, examination, laboratory, and neuroradiographic data will narrow the problem to one of several groups of agents, although it may not be possible to specify a single causative agent. It should be remembered that several concurrent infections (i.e., CMV and toxoplasmosis, aspergillosis, and bacterial sepsis) may be present. Thus, the clinician should rely on broad antibiotic coverage appropriate to the suspected causative agent or agents at the site of infection. It may be necessary to offer broad-spectrum antibiotic coverage for a CSF presentation that is subsequently found to result from a viral illness or from a noninfectious cause. However, one should avoid undertreating those infections for which specific therapy can be offered, and broad-spectrum treatment usually will not be regretted. Uncertainty in diagnosis following noninvasive procedures should lead to a brain biopsy. Although many of the infections discussed in this article have a poor prognosis, some of the most common pathogens, such as Cryptococcus, Listeria, and Toxoplasma, have effective specific therapies to which the patient should have access as rapidly as possible. The clinician who has successfully treated a patient with CNS infection should remain vigilant for late sequelae or recurrence of infection. Chronic treatment of some infections, such as toxoplasmosis or aspergillosis, may be necessary. The reintroduction of steroids for the treatment of an underlying cancer may reactivate previously treated disease, such as cryptococcosis, and periodic CSF surveillance is appropriate under these circumstances. Recurrence of the symptoms should raise the suspicion of recurrent or new infection, and the patient also should be evaluated with CT or MRI for the development of hydrocephalus or for new metastatic disease. In patients who have had varicella-zoster infection, postherpetic neuralgia and delayed arteritis may develop. Seizures, hearing loss, and neuropsychologic sequelae may follow any meningoencephalitis. The patient should always be reevaluated for the possibility of infection with a different opportunistic organism. CNS infections remain a major cause of morbidity and mortality in immunosuppressed patients with malignancies. In one series, 60% of such patients died as a result of their CNS infection, many at a time when the underlying disease had an otherwise good prognosis.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Central nervous system infections in cancer patients. 175 29

A total artificial heart was used to support the circulation in 33 heart transplantation candidates who were expected to die before procurement of a donor heart. Twelve of these patients (mean age 35 +/- 10 years) underwent cardiac transplantation. Another patient is still being supported with the total artificial heart 90 days after implantation. The other 20 patients died during mechanical support because their condition could not be stabilized for transplantation, despite blood flow restoration. Fifty-six percent of the patients younger than 40 years underwent successful transplantation and six of nine patients are long-term survivors. By comparison, in the older group, 17.6% of patients underwent transplantation and one of three survived long term. Forty-four percent of patients in the acute decompensation group had successful transplantation and four of seven patients are long-term survivors. In the chronic decompensation group these figures were 29.4% and three of five patients. All patients who were heavily immunosuppressed (n = 4) died of sepsis. Transplantation was considered and performed only when the patient's condition was correct and stable. In six patients an infection developed in the immediate posttransplant period. Three of the infections were resolved with antibiotic therapy. One originated in the mediastinum and is still unresolved, although the patient's condition is improving. Another patient died of an anoxic coma caused by ventilatory problems. There were two late deaths at 14 and 19 months, one resulting from a combination of toxoplasmosis and rejection and the other from a Kaposi sarcoma caused by azathioprine treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Orthotopic transplantation after implantation of a Jarvik 7 total artificial heart. 264 67

21 patients with hematological neoplasias (8 ALL, 4 AML, 4 NHL, 5 HD) were treated with high dose therapy and autologous bone marrow rescue (ABMT). At the time of ABMT 12 patients were in CR, 6 in PR and 3 in relapse. 66% of the patients were at high risk at the time of diagnosis. Before ABMT patients received an ablative regimen such as cyclophosphamide or ARA-C, VP-16, DNR and 12 Gy TBI in 6 fractions. In 9 patients the bone marrow was treated in vitro with monoclonal antibodies and complement. The hospital stay was a median 33 (24-57) days and isolation 19 (9-49) days. Complications were septicemia (7), herpes stomatitis (7), infections (6), fungal sepsis (1) and hemorrhagic cystitis (2). Late complications (up to 6 months after ABMT) were pneumococcal sepsis (1), cerebral toxoplasmosis (1) and herpes zoster (3). 10 of 19 evaluable patients are alive and relapse-free 1-33 months (median 10) after ABTM, and 3 of 10 more than 2 years later: 4 of 5 were transplanted in 1. CR, 4 of 6 in greater than or equal to 2. CR and 2 of 8 in PR. 4 patients are living in therapy sensitive relapse 2, 11, 11 and 39 months after ABMT in 2. CR or PR. 5 patients died 1-13 (median 3.5) months on relapse, 2 of 21 from septicemia. The morbidity of ABMT is comparable with conventional high dose chemotherapy. Relapse-free survival was significantly influenced by the remission status at ABMT. Long-term survivors can be expected even in patients with high risk hematological malignancies. However, only wider trials will serve to establish the efficacy of ABMT.
 ...
PMID:[Autologous bone marrow transfusion in the treatment of adults with hematologic neoplasms. Experiences from Bern]. 266 30

This retrospective hospital study concerns 159 infectious episodes observed in 60 patients with chronic lymphoid leukaemia (CLL) staged A, B or C on first admission. The most frequent site of infection was pulmonary (33%), followed by ENT and stomatological infections (15%), septicaemia (9%), urinary and genital tracts infections (9%), herpes virus infections (9%), skin and soft tissue purulent sepsis (8%), digestive tract (3%) and meningeal (1%) infections and isolated fever (8%). Seventy nine bacteria were isolated, including 35 Gram-positive cocci (Staphylococcus spp. 12, Streptococcus spp. 13, D. pneumoniae 5, Enterococcus spp. 5), 43 Gram-negative bacilli (Enterobacteriaceae 36, Pseudomonas spp. 5, Haemophilus influenzae 2) and 1 M. tuberculosis. The other documented infections were: candidiasis 11, viral infections 19 (including 17 of the herpes group) and 2 parasitoses (1 pneumocystosis, 1 toxoplasmosis). Sixteen patients died of toxic -infectious shock (9 cases, including 1 meningitis) or pneumonia (7 cases, including one chicken-pox). Stage C leukaemia and granulopenia (less than 1 X 10(9) PN/l) were associated with significantly more frequent and severe infections.
 ...
PMID:[Severe infections associated with chronic lymphoid leukemia. 159 infectious episodes in 60 patients]. 294 30

Patients with severe neutropenia are at increased risk for systemic infection with bacteria or fungi. This risk is in proportion to both the degree and duration of the neutropenic process. Although granulocyte transfusion as a means of augmenting host defenses would appear to be a logical therapeutic intervention in clinical contexts involving severe and prolonged neutropenia, several features of granulocyte physiology and collection complicate such considerations. These include the large numbers of granulocytes normally produced by healthy hosts, the short survival of the granulocyte in the circulation after transfusion, the relatively small number of granulocytes which can be collected using currently available pheresis techniques, problems associated with alloimmunization, and the possibility of transferring disease (CMV, toxoplasmosis, hepatitis) by means of these transfusions. In the mid-1970s, well-designed clinical studies strongly suggested that patients with documented Gram-negative sepsis or tissue infection that failed to respond to appropriate antibiotics were significantly benefited by granulocyte transfusions. With recent advances in potent, broad-spectrum antibiotic availability, some have questioned whether these observations remain valid. Several studies regarding the prophylactic use of granulocyte transfusions in patients undergoing allogeneic bone marrow transplantation and/or induction therapy for leukemia have failed to reveal therapeutic benefits and suggested the possibility of significant side effects. These studies are reviewed.
 ...
PMID:Granulocyte transfusions in neutropenic patients. 304 Feb 82

Between 1976 and 1985 necropsies were conducted on 55 free-living and 18 captive echidnas originating from several localities in Victoria, Australia. Injuries arising from motor vehicle accidents were the most common cause of death (24 of 55; 47%). An additional nine live echidnas were presented for clinical examination for dog or fox wounds (eight), or wire snare wounds (one). Incidental infestations with ticks (Aponomma concolor) on the skin or in the ear canal (eight of 82; 10%), and infections with intestinal cestodes (Linstowia echidnae) (nine of 73; 12%) and intestinal coccidia (three of 73; 4%) were found. Intestinal trichostrongyloidosis (four of 55; 7%), purulent bronchopneumonia (three of 55; 5%) and septicemia (three of 55; 5%) were the major disease syndromes seen in free-living echidnas. Other conditions seen were a non-specific enteritis, toxoplasmosis and bacterial granulomata. The latter lesion and the bronchopneumonia may have arisen from soil bacteria entering the body during digging and feeding activities. The echidna's ability to resist these infections may be lowered due to its low normal body temperature, and periods of torpor. Several young echidnas suffered starvation or gastric dilatation soon after capture, due to the rejection or fermentation of food offered. Captive echidnas suffered from acute salmonellosis (six of 18; 33%), toxoplasmosis (two of 18; 11%) and exposure (two of 18; 11%).
 ...
PMID:Morbidity and mortality of free-living and captive echidnas, Tachyglossus aculeatus (Shaw), in Australia. 373 83


1 2 3 4 5 Next >>