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)

A Reverse Passive Haemagglutination Test (RPHA) was designed for the detection of Salmonella typhi antigen and rapid diagnosis of typhoid fever. Two per cent fresh sheep RBC's were coated with 32 micrograms/ml of immunoglobulin. The minimal detectable level of the antigen was 1250 micrograms/ml. Cross reactions were observed with the samples of patients suffering from Salmonella paratyphi A and pseudomonas infections. The RPHA established was used for the detection of S. typhi antigen in culture broths from 100 patients with clinically suspected typhoid fever with culture and/or widal positive, 50 patients with septicemia caused by bacteria other than S. typhi and 50 normal, afebrile healthy controls. It was found that the sensitivity and specificity of this assay was 70% and 92% respectively.
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PMID:Rapid diagnosis of typhoid fever. 1077 5

Two hundred and forty eight cases of proved typhoid ileal perforation were admitted and treated in three phases in the department of surgery during 1966-1998. Of these, 71% patients belonged to second and third decades of life. Male female ratio was 4:1. Abdominal pain (100%) fever (95%) and constipation (87%) were the main presenting symptoms. Abdominal guarding and rigidity (84%) were the principal physical signs. Plain radiograph of abdomen showed evidence of pneumoperitoneum in 57% of cases. The Widal test was positive for S. typhi in 74% of cases. Blood and bone marrow culture were positive for S. typhi in 9% and 30% respectively. Histology of the excised edges of perforation confirmed typhoid pathology in 62% of specimens. Many of the patients were treated conservatively in the first phase. In phase two and three vigorous resuscitation and early surgery was resorted to. Simple closure in two layers and wedge resection were the treatment of choice in most of the cases. Bypass, ileostomy and resection were done on few occasions. Chloramphenicol was the only drug used in the first phase. Other broad spectrum antibiotics were added to chloramphenicol with metranidazole in the second phase. Ciprofloxacin and metronidazole were the drugs of choice in the third phase. The mortality rate showed a dramatic improvement from 47.2% (first phase) to 17.7% (second phase) and as low as 7% in the last phase. The lag period (advent of symptoms to time of admission to hospital) showed definite correlation with mortality. Septicemia, wound infection, dehiscence, enterocutaneous fistula were the principal postoperative complications.
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PMID:Changing trends in outcome of typhoid ileal perforations over three decades in Pondicherry. 1168 Nov 12

Corticosteroids were proposed to treat patients with severe sepsis as early as 1940. A summary of all available randomized controlled trials performed between 1966 and 1993 was provided in two systematic review that recommended to abandon the use of high dose coricosteroids to treat patients with severe infection. Nonetheless, a doubt still persist regarding the efficacy of a strategy of replacement therapy in cathecolamines-dependent shock. This strategy relies mainly on the concept that septic shock may be complicated by 1) an occult adrenal insufficiency, 2) a glucocorticoid peripheral resistance syndrome. Some studies demonstrated the effect of replacement therapy with hydrocortisone on the sistemic inflammatory response and on the cardiovascular function during sepsis. The effect of this therapy on survival to septic shock is controversial both in recent and old studies. Finally a recently completed multicenter, placebo controlled, randomized, double-blind study has evaluated the efficacy and tolerance of a replacement therapy with a combination of hydrocortisone (50 mg intravenous bolus four times per day) and fludrocortisone (50 g orally once a day) given for 7 days. This study included 300 catecholamines- and ventilator-dependent septic shock. The authors found a significant reduction in 28-day mortality in patient with occult renal insufficiency. In sum, short course with high doses of corticosteroids should not be given in severe sepsis, except for specific entitles like severe typhoid fever, pneumocystis carinii pneumonia in AIDS or bacterial meningitis in children. The rational for a replacement therapy with hydrocortisone in catecholamines-dependent septic shock grows stronger.
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PMID:Resurrection of steroids for sepsis resuscitation. 1202 69

A study of 165 maternal deaths at the University of Benin Teaching Hospital, Benin City over a 13-year period (from April 1, 1973 to December 31, 1985) is presented. All patients' case files were recovered from the central records library and each case file was carefully analyzed. With a total delivery of 29,324, the maternal mortality rate, inclusive of death from abortion, was 563/100,000 deliveries. There was a general increase in maternal mortality rate with age and this became alarming from 35 years. There was an equally high mortality rate among teenagers, mainly accounted for by illegally induced abortion. Indeed, abortion accounted for 72% of teenage mortality. A statistically significant association between maternal deaths and parity (p, 0.001) was observed. The most important causes of death were hemorrhage with a total of 26 out of 42 deaths, sepsis, and abortion. Other important causes were hypertensive disorders such as eclampsia, liver and respiratory disease, anemia, trophoblastic diseases, caesarean sections, and acute renal failure. Additional causes of maternal deaths include tetanus, sickle-cell disease, anesthetic death, drug reactions, pulmonary embolism, acute pyogenic meningitis, typhoid disease, urinary bladder tumor, acute lymphoblastic leukemia, and carcinoma of the breast thyroid. Factors identified with these deaths included such health services factors as deficient medical treatment of obstetric complications, lack of adequate personnel at primary and secondary health care levels, lack of access to maternal health services, and consequently, lack of prenatal care. Extreme reproductive age, grandmultiparity, and unwanted pregnancies, especially among teenagers, also contributed to maternal deaths. Overhaul of the maternal health care services at national level to include organization of such programs as provision of adequate blood transfusion facilities, prompt treatment of infections, early referrals of patients at risk to secondary and tertiary health centers, intensified family planning programs, and liberalization of abortion laws are recommended in order to reduce the unacceptably high maternal mortality.
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PMID:Maternal mortality at the University of Benin Teaching Hospital Benin City, Nigeria. 1217 71

Typhoid fever is rare in Europe, but well-recognized endemic disease in tropical zones. We report our findings in a series of 25 cases of typhoid fever during pregnancy observed in French Guiana and reviewed the literature on clinical signs, diagnosis and treatment. Salmonellea typhi causes septicemia of digestive origin that can cross the placenta resulting in chorioamniotitis. Maternal-fetal infection with S. typhi can lead to miscarriage, fetal death, neonatal infection, as well as diverse maternal complications. In order to avoid maternal complications and possible fetal transmission, treatment with ceftriaxone should be initiated as early as possible
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PMID:[Typhoid fever and pregnancy]. 1237 34

To determine the factors affecting morbidity in patients with typhoid intestinal perforation (TIP), 42 patients who had been operated upon for TIP between 1990 and 2000 were reviewed. The average age was 10.4 years, the male-to-female ratio 2.5/1. The mean interval from admission to operation was 6 h. Twenty-three children had multiple perforations. Primary closure (PC) was performed in 55% of the patients, ileostomy in 26%, and resection with anastomosis (RA) in 19%. Parenteral nutrition (PN) was available for 22 patients for an average of 9 days. Postoperative complications occurred more commonly in patients with delayed admission and/or severe peritonitis. Hospitalization was shorter and the postoperative complication rate lower in patients who received PN and in those who underwent ileostomy. None of the patients developed an enterocutaneous fistula. The 2 deaths (4.8%) resulted from overwhelming sepsis. The most significant factors affecting morbidity were prolongation of perforation-operation interval and severe peritonitis. No operative procedure is likely to be the best in all cases; therapy should be individualized. Ileostomy appears to be an effective procedure, particularly in patients with severe abdominal contamination and delayed presentation. The use of PN in addition to standard medical and surgical therapy in patients with TIP may be beneficial.
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PMID:Factors effecting morbidity in typhoid intestinal perforation in children. 1259 67

Two patients with AIDS and severe immunodeficiency developed typhoid fever. The diagnosis was confirmed by isolation of Salmonella typhi from blood cultures, while Widal's serum test isolates proved in vitro sensitive to all tested antimicrobial agents, and complete recovery was obtained with i.v. cotrimoxazole and piperacillin treatment. Unlike complications by non-tiphoid Salmonellae, S. typhi infection has been infrequently reported in the context of AIDS: to our knowledge, only five cases of typhoid fever have been described in HIV-infected living industrialized countries. Medical history and epidemiological information may play an important role in prompting the search for an S. typhi infection in patients coming from endemic regions, since most of the sign and symptoms of typhoid fever may mimic those of a sepsis. Or other AIDS-related complications
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PMID:Salmonella typhi disease in HIV-infected patients: case reports and literature review. 1272 6

Intrapericardial (Pericardial) abscess is quite rare as a complication of sepsis and as a cardiac complication of typhoid septicaemia. It is rapidly fatal if untreated. We report two cases of a schoolboy eight years old with septicaemia from pyomyositis of the right thigh and another of nine and a half years with typhoid perforation and typhoid septicaemia that developed pericardial abscesses. In well-developed centres, computerised tomography, ultrasonography and other radiological investigations are employed for both diagnosis and therapy. We emphasise that these can be accomplished by good clinical examination, radiography of chest and the use of 18-G intra-venous cannula for percutaneous pericardiocentesis without aggressive surgical intervention.
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PMID:Purulent pericarditis complicating septicaemia: report of two cases. 1295 44

Type III secretion systems enable plant and animal bacterial pathogens to deliver virulence proteins into the cytosol of eukaryotic host cells, causing a broad spectrum of diseases including bacteremia, septicemia, typhoid fever, and bubonic plague in mammals, and localized lesions, systemic wilting, and blights in plants. In addition, type III secretion systems are also required for biogenesis of the bacterial flagellum. The HrcQ(B) protein, a component of the secretion apparatus of Pseudomonas syringae with homologues in all type III systems, has a variable N-terminal and a conserved C-terminal domain (HrcQ(B)-C). Here, we report the crystal structure of HrcQ(B)-C and show that this domain retains the ability of the full-length protein to interact with other type III components. A 3D analysis of sequence conservation patterns reveals two clusters of residues potentially involved in protein-protein interactions. Based on the analogies between HrcQ(B) and its flagellum homologues, we propose that HrcQ(B)-C participates in the formation of a C-ring-like assembly.
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PMID:Structure of HrcQB-C, a conserved component of the bacterial type III secretion systems. 1469 3

We report a case of typhoid fever in an 8 years old boy. The child was initially admitted to a local hospital where pneumonia, myocarditis with heart failure, pyelonephritis, liver and pancreatic failure as well as cholelithiasis were suspected. Zinaceff and Amikin were administered and after 8 days the child was referred to the cardiology department of a regional reference hospital due to heart failure symptoms. There the diagnosis of sepsis was established, and the antibiotics changed to Pipril and Amikin. The child however did not improve and after two days he was transferred to an intensive care unit. The previous anti-microbial therapy was continued for another 7 days until the results of stool culture revealing Salmonella sp. were available. Subsequently the boy was admitted to our clinic. Based on the clinical course, Widal test and isolating of the Salmonella typhi from the stool samples typhoid fever was diagnosed.
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PMID:[Typhoid fever in a child--a case report]. 1521 62


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