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

Clinical records of 181 children, aged between one month and seven years, admitted in a four year period, from 1978 through 1982, with the diagnosis of bacterial meningitis are revised. Peak incidence occurred in the age group between six months and three years, and during the months of January to May. N. meningitidis (35%), pneumococcus (4.9%) and H. influenzae (2.7%) were the most frequently isolated bacteria. CSF culture was negative in 56% of the children. All of them had previously taken antibiotics. Complications were present in 6.4%, with highest incidence in the known-agent group, on the following order: septic shock, 11%, seizures, 6.6%, and subdural effusion, 2.2%. Permanent sequelae were present in 3.8%, being deafness predominant. Twelve (6.3%) out of the 181 died, and death was result of fulminant meningococcal sepsis with endotoxic shock in ten of these patients. Clinical and psychological followed-up of twenty-nine children with isolated causal agent, were compared with a control group, finding no statistically-significant difference.
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PMID:[Bacterial meningitis in children. Analysis of 181 cases]. 650 29

In an attempt to develop a rational basis for performing lumbar puncture in sepsis workups, the hypothesis was tested that, for each of eight variables with a known association with bacteremia, the frequencies for patients having bacterial meningitis would be significantly greater than those in patients having bacteremia alone. In a one-year period, 168 lumbar punctures were performed in children having a mean age of 7.3 months. Patients were assigned to four groups: bacterial meningitis, bacteremia only, aseptic meningitis, and normal. Mean age, frequencies of symptoms, clinical appearances, ethnic groups, and sex ratio were determined for all groups. Frequencies of eight variables were determined and compared between Groups I and II.Results indicated that frequencies were not significantly different for groups I and II and that lethargy and petechiae, although distinguishing between groups I and IV, did not distinguish among the three groups having serious disease. It was concluded that since one cannot distinguish among groups having serious disease, all such patients suspected of sepsis should undergo lumbar puncture.
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PMID:Should lumbar puncture be routinely performed in patients with suspected bacteremia? 665 17

To investigate the relative importance of the many possible influencing factors and developmental traits of systemic meningococcal disease (MCd) in the practical Norwegian context, a comprehensive multipurpose case control study was carried out during the winter of 1981-1982 on incident cases in the whole country. The design of the study, the MenOPP project, is outlined. The main inclusion criteria for patients were suspected bacterial meningitis and/or septicemia on referral to hospital. This resulted in 115 verified or probable cases of MCd and 61 patient controls. Randomly drawn from three age strata, 320 population controls were actually approached and 293 (92%) of these responded to the "environmental questionnaire". So did most of the patients (98%). The clinical data mainly comprised information from the commencement of the disease to a sequelae check about six weeks after hospital admission. Laboratory data on strain and serum characteristics were, and still are, collected. The results are to be published in several papers. Here, some epidemiological characteristics of the material are given. Regional, seasonal, and age/sex differences in case fatality are reported and discussed.
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PMID:An epidemiological, clinical and microbiological follow-up study of incident meningococcal disease cases in Norway, winter 1981-1982. Material and epidemiology in the MenOPP project. 667 81

The records of all patients with Staphylococcus aureus meningitis admitted to Vancouver General Hospital between 1956 and 1981 were reviewed. All the patients had clinical and laboratory features of meningitis, and in all cases S. aureus was isolated from the cerebrospinal fluid. S. aureus was responsible for 21 (3%) of the 710 cases of acute bacterial meningitis. Therapy with cloxacillin or methicillin, or both, with or without other agents, was successful in 14 of the 21 patients. Three of the 14 patients without ventricular shunts died, 2 with fulminating septicemia and 1 with a postoperative brain abscess treated with cloxacillin. Following shunt removal and antibiotic therapy all seven patients with ventricular shunts survived the infection. Shunt removal may therefore be essential in appropriate cases.
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PMID:Staphylococcus aureus meningitis: 26 years' experience at Vancouver General Hospital. 685 Apr 67

Clinical evaluation of cefmetazole were made in the treatment of bacterial infections in the newborn infants and the following results were obtained. 1) Five infants, 7 approximately 58 days of age, received a single intravenous one-shot injection of 22.2 approximately 24.5 mg/kg dose of cefmetazole, and blood concentrations were determined. The average level was 62.6 micrograms/ml (30 minutes), 46.3 micrograms/ml (1 hour), 26.8 micrograms/ml (2 hours), 8.7 micrograms/ml (4 hours) and 2.4 micrograms/ml (6 hours), and T 1/2 was 87.7 minutes. Almost similar values were obtained when the drug was given by a 30-minute drip infusion and sufficiently exceeded the MIC to the bacteria to which cefmetazole was indicated. 2) In two patients, who had been operated for choledochal cyst and received an intravenous drip infusion of the drug, the persistence of the blood concentration was remarkably long, T 1/2 being 192 and 222 minutes, respectively. This problem still remains to be elucidated. 3) The following 22 patients were treated with an intravenous one-shot or drip infusion of cefmetazole, i.e., 45.6 to 107.1 mg/kg divided in 2 approximately 3 doses; 14 patients aged 1 to 21 days, 2 aged 1 to less than 2 months, 3 aged 2 to less than 3 months and 3 aged older than 3 months. However, in purulent meningitis, larger dose was given intravenously 6 times daily. Diseases included sepsis (4 cases), purulent meningitis (3), peritonitis (1) SSS syndrome (3), subcutaneous abscess (2), urinary tract infection (8) and Salmonella enteritis (1), and their causative organisms were E. coli (13 strains), K. pneumoniae (1), S. typhimurium (1), S. aureus (6) and group B Streptococcus (1). Overall efficacy rate in 22 cases was 90.9%. i.e., excellent in 11, good in 9 and failure in 2. Two cases of failure were a patient with peritonitis and visceral eventration due to umbilical hernia and a patient with a chromosomal aberration and urinary tract infection caused by E. coli. Reasons for such a treatment failure appeared to reside in host factors. 4) Adverse reactions included each one case of skin rash and diaper rash, 3 cases of eosinophilia and 5 cases of elevation of transaminase levels, all of which were mild and transient. 5) Based on the above results, cefmetazole is considered to be a potent new antibiotic which should be indicated as the first choice drug in the treatment of neonatal bacterial infections. The recommended dosage is as follows: 50 mg/kg given intravenously 6 times daily for bacterial meningitis and 20 approximately 25 mg/kg intravenously or by a drip infusion 2 to 3 times daily for other infections.
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PMID:[Cefmetazole in the treatment of bacterial infections in the newborn (author's transl)]. 694 Oct 35

Cefmetazole (CMZ) is an antibiotic agent belonging to the cephamycin group, which is resistant to beta-lactamase and has a broad antibacterial spectrum covering from Gram-negative to -positive organisms. Although this agent has been proved to have an antibacterial activity against Staphylococcus spp., it has not been used for treatment of the infections caused by the organism. Thus, 62 strains of S. aureus isolated clinically were compared for their sensitivity to CMZ, cefoxitin (CFX), cefuroxime (CXM), cefazolin (CEZ), and ampicillin (ABPC). In addition, 5 children suffering from septicemia due to S. aureus were treated with CMZ 158 mg/kg at a mean daily dose for a mean period of 14 days. The dose was used after dividing into 3 and 4 equal parts in 1 and 4 children, respectively. One old patient with septicemia was given 2,000 mg of CMZ twice daily for 4 days and once daily for subsequent 3 days. Another child with bacterial meningitis was treated with 50 mg/kg of CMZ 4 times daily for 63 days. The drug was given intravenous injection by one-shot or drip infusion in all cases under observation of clinical effects, bacteriological effects and side effects. The MIC of CMZ against S. aureus at inoculum sizes of 10(6) and 10(8) cells/ml was 1.56 mcg/ml in 72.6 and 56.5% of the strains, respectively. When 5 drugs were compared on the basis of the MIC to which the largest number of strains were sensitive, CEZ was most active, and CMZ was ranked in the next place and similar to CXM in activity. However, when the whole range of the MIC was considered, CMZ was more excellent than CXM, its MIC was lower than those of CEZ, CFX and ABPC in a greater number of strains. It was considered from the results that the serum level of CMZ was effective against 100 and 93.5% of strains at an inoculum size of 10(6) cells/ml and against 100 and 83.9% of strains at an inoculum size of 10(8) cells/ml until 4 and 6 hours after a one-shot intravenous injection of 50 mg/kg of Moni-trol I standard, respectively in the children. Thus, CMZ is expected to manifest a sufficient effect on septicemia caused by S. aureus in children who receive a one-shot intravenous injection of 50 mg/kg of it 4 times daily. Treatment with CMZ was clinically evaluated to be excellent in 3, good in 3 and poor in none of 6 patients with septicemia due to S. aureus, and fair in the 1 with Staphylococcal meningitis. The bacteriological result was excellent, since the causal organisms were eradicated in all cases. With regard to side effects, abnormal eosinophilia was found in 2 cases, but it was no ascribable to this drug in 1 of them. GOT showed an abnormal rise in 1 case and both GOT and GPT in 1, although they were considered not to be related to this drug in either case. It is considered from these results that CMZ is a valuable drug in treatment of septicemia due to S. aureus.
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PMID:[Laboratory and clinical studies of cefmetazole in serious infection by Staphylococcus (author's transl)]. 695 89

Meningitis and septicemia due to Serratia marcescens developed in a patient postoperatively after stapedectomy. The infection with this organism is rare but has to be considered in differential diagnosis of bacterial meningitis because the early treatment with intrathecal administration of antibiotics may be lifesaving. Most of the reported cases of meningitis due to Serratia were due to S marcescens.
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PMID:Fatal meningitis due to Serratia marcescens after stapedectomy. 703 85

Elderly persons are prone to more frequent or greater morbidity and higher mortality from selected infectious diseases than the average population. Factors that may affect this increased predilection or poorer prognosis include environmental exposure, normal physiological changes of aging, coexistence of chronic diseases and alteration of host defense mechanisms. Infections to which the aged are particularly vulnerable are pneumonia, influenza, tuberculosis, urinary tract infection, Gram-negative bacteremia, intra-abdominal sepsis, soft tissue infection, infective endocarditis, bacterial meningitis, bacterial arthritis and herpes zoster infection.
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PMID:Important infections in elderly persons. 703 32

A parenteral formulation of rifampicin (Rimactan i.v., Ciba-Geigy, Basel, Switzerland) was administered to 237 critically ill or comatose patients, or patients with gastro-intestinal or absorption problems. There were 160 patients suffering from tuberculosis, 77 suffering from non-tuberculous (non-tb) infections including 30 cases of sepsis, 8 cases of bacterial meningitis and/or cerebral abscess and 9 patients with Legionnaires' disease. The usual daily dose of rifampicin was 450-600 mg, administered in most cases by i.v. bolus (122 cases) or i.v. drip infusion (79 cases) for a period of 1-113 days. Rifampicin was in all cases combined with one or more antimicrobial drug(s). The physicians considered the therapy as successful when the treatment with oral rifampicin could be instituted soon after parenteral administration or when the patients markedly improved their clinical condition. Of a total of 123 tuberculous patients for whom assessment of efficacy was possible, 100 (81.3%) showed favourable clinical results. Of 40 non-tb patients who could be analysed for clinical progress, 32 (80.0%) had a favourable outcome. Special attention should be drawn to the 11 patients with proven staphylococcal infections, of whom 10 were cured clinically and/or bacteriologically. Thrombophlebitis occurred in 10 out of the 237 (4.2%) patients, almost always in patients who were treated for more than 30 days. Systemic unwanted effects occurred in 14 (5.9%); the relationship to the treatment was not always established. Treatment was withdrawn due to unwanted effects in 5 (2.1%) of the 237 patients. Taking into account the severe, life-threatening infections reported, the results suggest that i.v. rifampicin is useful and in some critically ill patients even life-saving. Tolerability was good, even in long-term i.v. administration, although there seems to be the possibility that thrombophlebitis might develop if treatment is continued over 30 days.
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PMID:Parenteral rifampicin in tuberculous and severe non-mycobacterial infections. Clinical data on 237 patients. 709 64

To determine whether all febrile outpatients below the age of two months should be routinely hospitalized and given parenteral antibiotics because of the possibility of occult sepsis or meningitis, 147 such admissions were reviewed over four years. None of the neonates had occult bacterial meningitis, while one may have had occult sepsis. Because serious infections may have been missed in outpatients not hospitalized, the outcome of all such illnesses seen in the clinic during a subsequent six months was monitored; none of 17 hospitalized or 20 followed as outpatients experienced sepsis or meningitis. If our findings are confirmed in other studies, febrile outpatient neonates with a well appearance, normal cerebrospinal fluid and physical examination, and dependable follow-up may not require universal hospitalization and antibiotics.
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PMID:Management of febrile outpatient neonates. 722 92


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