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

Because of degenerative joint diseases and the reduced resistance in older patients the correct diagnoses of joint-empyema is difficult. In 29 pat (> 60 y) the mean delay of diagnoses was 5.1 months. First location of the infection have been: urinary tract 12, pneumonia 6, skin infection 10, and decubitus 3. Risk factors have been diabetes 4, polyarthritis 3, gout 3 and tuberculosis 3. The species were: s. aureus 12, s. albus 2, streptococcus 2, diphtheroid 2, e.coli 2, pseudomonas 2, proteus 4, enterobacter 3 and salmonella 1. 8 patients demonstrated mixed infections. The high mortality (3 pat.) and the frequent general sepsis (5 pat.) underline the importance of a missed joint-empyema in the elderly.
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PMID:[Joint destruction and infection in advanced age]. 783 47

In February 1992 in Nigeria, pediatricians and community health workers interviewed parents living in 1263 households in the rural tropical rainforest community of Nko in Ugep Local Government Area of Cross River State to determine the pattern of infant and child mortality in a typical rural community and to examine family and social patterns which may influence child mortality. There were no records of birth and death in Nko. They identified 471 pediatric deaths (=or 15 year olds) that occurred during 1991. Children between 1 and 5 years old comprised the largest group of pediatric deaths (43.3%) followed by those older than 5 years (33.3%), 1-12 month old infants (18.1%), and newborns (5.1%). The leading causes of neonatal death were septicemia (37.5%), tetanus (20.8%), and birth asphyxia (20.8%). The leading causes of infant death included malaria (46.5%), protein energy malnutrition (PEM) (10.5%), pneumonia (10.5%), and diarrhea (10.5%). Among preschoolers (1-5 year olds), the major causes of death were malaria (35.8%), PEM (18.1%), and diarrhea (13.7%). Pneumonia (16.6%), malaria (15.3%), and tuberculosis (13.4%) were the chief causes of death among school-aged children. Among all 471 pediatric deaths, malaria was the leading cause of death. Pediatric deaths peaked in the months of March and August, periods of high malaria transmission during the transitional period from dry to wet season and from wet to dry season. Only 5% of the deceased children had adequate immunization coverage. 52.9% of the children were not treated in health facilities, as the nearest health facility was in the town of Ugep, 15 km away from Nko. Insufficient waste disposal, lack of potable water, and streams polluted with human wastes contribute to the diarrhea deaths. An open toilet system, bushes littered with domestic wastes, and no water drainage system are breeding grounds for mosquitoes. Overcrowding in the homes foster the spread of infections. Protein-poor root crops predominate, leading to PEM.
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PMID:Community-based surveillance of paediatric deaths in Cross River State, Nigeria. 785 18

The frequency of basic diseases, complications, causes of death and associated illnesses were studied on non selected autopsy material of 161 patients with rheumatoid arthritis died at the National Institute of Rheumatology in 1970-1992. The authors determined the incidence of severe complications such as systemic vasculitis, generalized secondary amyloidosis, generalized septic infection and miliary epithelioid granulomatosis (probably miliary tuberculosis). In 122 cases (75.8%) the RA, while in the remaining 39 (24.2%) cases other basic disease was the underlying cause of death. Vasculitis was observed in 36 cases (22.4%), amyloidosis in 34 (21.1%), sepsis in 22 (13.7%), and miliary tuberculosis in 6 (3.7%) out of 161 RA patients. Vasculitis led to death in 19 (11.8%), amyloidosis in 17 (10.6%), sepsis in 22 (13.7%) cases. However, none of the miliary tuberculosis was direct cause of death. In 76 cases (47.2%) rheumatoid arthritis was not complicated by vasculitis, amyloidosis, sepsis or military tuberculosis and in 85 cases (52.8%) one or more of these complications existed in the necropsy material of 161 RA patients. In 74 patients (46%) only one complication and in 11 (6.8%) more than one from the mentioned complication existed simultaneously in the same patients. Vasculitis was detected clinically in 7 patients (relative frequency: 19.4%), amyloidosis in 8 (relative frequency: 23.5%), sepsis in 10 (relative frequency: 45.4%), however none of the 6 mT was detected clinically. Out of 98 complications in 85 Rheumatoid patients only 25 were recognized clinically (25.5%).
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PMID:[Causes of death as well as complications in rheumatoid arthritis]. 793 10

A 26-year-old male who had been diagnosed as pulmonary tuberculosis three years ago with an antituberculous chemotherapy of only two months, complained of tiredness, exertional dyspnea and fever since a month ago. Bloody sputum, bloody stool and hematuria have developed three days before admission. Petechiae over the body trunk and lower extremities were observed on admission. Peripheral blood examination revealed lymphocytopenia (672/microliters), low hemoglobin content (6.2 g/dl), thrombocytopenia (3,000/microliters), elevated FDP (36.2 micrograms/ml) and D-dimer (25.0 micrograms/ml) values. Chest radiograph showed a massive pleural effusion in the right hemithorax, bilateral pulmonary infiltrates and a cavity on CT scan. Together with positive acid-fast bacilli in sputum, diagnoses of relapsed pulmonary tuberculosis, tuberculous pleurisy associated with DIC (disseminated intravascular coagulation) were made. Left hydronephrosis which was presumed to be a consequence of infundibulum stenosis due to renal tuberculosis, was detected by abdominal ultrasonography. Treatment with antituberculous drugs and protease inhibitors were started with thoracic tube drainage. DIC condition was improved by the 20th hospital day and sputum culture turned to be negative after the 4th week, however, fever up to 38 degrees C continued until the end of the 7th week and a D-dimer which is a representative marker for secondary fibrinolysis, continuously showed a high level up to the 10th week of hospitalization. The patient was uneventful during the three months follow up period after discharge. DIC is a well known complication of sepsis including miliary tuberculosis, whereas it is rarely associated with cavitary tuberculosis and no case of prolonged elevation of D-dimer have been reported.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of pulmonary, pleural, and renal tuberculosis associated with DIC and a prolonged increase in D-dimer]. 804 Oct 60

A prospective study of 90 children admitted to Ethio-Swedish Children's Hospital in Addis Ababa, Ethiopia, in 1992 with severe protein-energy malnutrition assessed the clinical profile and patterns of infection. The children, who ranged in age from 4 to 60 months, suffered from marasmus (49%), marasmic-kwashiorkor (42%), and kwashiorkor (19%). Septicemia, the most alarming complication of severe protein-energy malnutrition, was present in 32 children (36%); gram-negative enteric bacilli were the most common bacterial pathogen. 57 children (63%) had pneumonia and 23 (26%) had tuberculosis. Another 33 (37%) had a urinary tract infection. 17 children (19%) presented with diarrhea, 33 (37%) had clinical and radiologic evidence of rickets, and 15 (17%) had clinical evidence of vitamin A deficiency. There were 29 deaths in this series (from septicemia, gastroenteritis, pneumonia, and disseminated tuberculosis), for a case fatality rate of 32%. Mortality was significantly greater among children with a total serum protein of 5 gm% or less and those with systemic infection. This profile differs from those recorded in other developing countries, suggesting that severe protein-energy malnutrition has clinical and geographic heterogeneity.
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PMID:Clinical profile and pattern of infection in Ethiopian children with severe protein-energy malnutrition. 806 77

A woman aged 63 presented with septic fever, followed by hepatocellular jaundice. Viral hepatitis was ruled out by serologic tests, but no definite diagnosis could be made. Due to severe disturbance of the plasmatic coagulatory system and a serum bilirubin level above 4 mg/dl, a liver biopsy was not performed. The patient had a persistent septicemia refractory to Imipenem. In spite of intensive care measures, the patient died of disseminated intravascular coagulation and multiorgan failure caused by septic shock. The correct diagnosis of miliary tuberculosis was made only post mortem by histopathological examination of liver specimens and confirmed by detection of Mycobacterium tuberculosis DNA in the patient's liver by polymerase chain reaction.
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PMID:[Miliary tuberculosis of the liver as a cause of septic shock with multi-organ failure]. 816 13

In East Africa, bacteremia is more common in hospitalized human immunodeficiency virus (HIV) type 1-positive than -negative patients. In 1991, blood cultures and clinical and laboratory data were obtained from 319 patients in Ivory Coast, where both HIV-1 and -2 infections occur. Forty-three bacterial, 10 mycobacterial, and 8 fungal pathogens were isolated from blood of 54 patients (17%). Pathogens isolated significantly (P < or = .05) more frequently from HIV-positive than -negative patients were nonmycobacterial bacteria, particularly Salmonella enteritidis; mycobacteria, particularly Mycobacterium tuberculosis-Mycobacterium bovis; and yeast or fungus. HIV-1 or -2 positivity was associated with a 3-fold increased risk for septicemia (P < .02). HIV-positive patients with fever or with lymphocyte counts < 1000 were more likely to be septicemic than those without these characteristics. Mortality increased significantly with HIV positivity (40% vs. 14%, P < .001) and, among HIV-positive patients, with having pathogens isolated from blood (63% vs. 33%, P < .001).
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PMID:Pathogens and predictors of fatal septicemia associated with human immunodeficiency virus infection in Ivory Coast, west Africa. 839 59

The following findings were obtained from autopsies performed on 169 deceased with chronic polyarthritis (CP): systemic vasculitis in 26 cases (15.4%), systemic secondary amyloidosis in 32 cases (18.9%), sepsis in 13 cases (7.7%) and miliary epithelioid-cell granulomatosis (probably tuberculosis) in six cases (3.6%). Vasculitis was combined with amyloidosis in five patients, with sepsis in two and with miliary epithelioid-cell granulomatosis in four. Critical random check, using the Mann-Whitney test, did not support significance of relationship between vasculitis and amyloidosis or fatal sepsis, whereas significant correlations were found to exist in CP cases between vasculitis and miliary epithelioid-cell granulomatosis (P < 0.005). The latter had no effect on the severity of vasculitis, but the incidence of the granulomatous type of vasculitis was higher with significance (P < 0.02). The conclusion is that biopsy evidence of granulomatous vasculitis in CP patients should be followed by systematic clinical search for miliary tuberculosis because of above-average incidence of that combination.
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PMID:[Disease-modifying factors in chronic polyarthritis. Correlations amongsystemic vasculitis, secondary amyloidosis, septic infections and occurrence of miliary epitheloid-cell granuloma. A review of autopsies]. 849 20

The operative approach to constrictive pericarditis still remains a surgical challenge. Subtotal pericardiectomy through median sternotomy was analyzed retrospectively in a series of 84 patients operated on for chronic constrictive pericarditis at our institution between 1979 and 1989. The mean duration of symptoms prior to diagnosis was 20 +/- 6 months (1-264 months). Preoperatively, 72% of patients were in NYHA class III or IV, presented signs of right cardiac failure (88%) or anasarca (18%). Chest X-ray showed pericardial calcifications in 40% of the patients. Echocardiography revealed pericardial thickening in 62%. Among 62 patients in whom cardiac catheterization was performed, a characteristic dip-and-plateau was found in 47 patients (76%). A specific etiologic factor was identified in only 37 patients: tuberculosis (12%), recurrent acute pericarditis (9%), hemopericardium (9%), radiotherapy (5%), previous cardiac surgery (4%), bacterial infection (2%), myocardial infarction (2%) and connective tissue disease (2%). In 47 patients (55%), the constrictive pericarditis remained idiopathic. In seven patients we performed a redo-operation for previous incomplete pericardiectomy. Subtotal pericardiectomy (from phrenic nerve to phrenic nerve) was performed in 75 patients. A palliative procedure consisting of pericardial "meshing" was performed in nine patients due to an unsatisfactory cleavage plane. Cardiopulmonary bypass was used in four patients for coexistent cardiac lesions. The operative mortality was 2.3% (two patients: septicemia and pulmonary embolism). Seven patients (8.2%) developed early on-lethal complications. The probability of survival for patients discharged for the hospital was 94% at 3 years and 87% at 7 years. There were four late deaths and no reoperation for recurrent constriction.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Results of subtotal pericardiectomy for constrictive pericarditis. 851 53

There is considerable mortality in sub-Saharan Africa relative to other regions in the world. No country in Africa, however, has a system of vital registration capable of providing reliable national data on mortality. Accurate information on the causes of adult mortality is therefore very limited. This lack of knowledge is becoming especially important in light of the impact HIV infection and AIDS are having in many sub-Saharan African countries. The authors documented the pattern of adult medical deaths in Queen Elizabeth Central Hospital, Blantyre, Malawi between April 1992 and March 1993. Their findings were then compared with data on mortality collected from the same wards in 1973, before the AIDS pandemic. Tuberculosis (TB) and AIDS together accounted for 49% of all medical deaths in 1992-93, with 82% of deaths occurring among individuals aged 13-49 years. TB, AIDS, gastroenteritis, pneumonia, pyogenic meningitis, and septicemia were the most important causes of death. In 1973, TB was responsible for 13% of deaths and there were no deaths due to AIDS. The authors note that the predicted upsurge in the level of AIDS-related mortality in sub-Saharan Africa during the 1990s will have grave consequences for the health sector, as well as for the social and economic fabric of the countries concerned.
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PMID:The changing pattern of mortality in an African medical ward. 856 May 90


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