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

Diagnosis of systemic candidiasis is difficult and often performed lately. It can be improved by Candida antigen detection, using agglutination of latex particles sensitized with anti-Candida albicans antibody. Candida antigen search was made in 407 sera obtained from 123 patients, in Hematology and in intensive care units. Fourty three patients had, at least, one serum positive for antigen. The titer was 1/2, 1/4 and 1/8. Twenty seven of the 43 patients had C. albicans in one or several localizations. Eight of these 27 patients had a systemic candidiasis: C. albicans grown from three blood samples, at least, and/or from organ biopsy. In these eight patients, the antigen titer was 1/4 ou 1/8. Eighty patients were Candida antigen negative. Thirty eight out of 80 had C. albicans in one or more sites and two of these 38 had systemic candidiasis. Five other patients had other Candida species. Two out of five had C. tropicalis and C. guillermondii septicemia.
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PMID:[Values and limitations of the detection of circulating Candida antigen (Cand-Tec) in the diagnosis of deep candidiasis]. 342 90

Isolation of Candida albicans from the vaginal secretions of pregnant women occurs with an incidence of 5-23%. Intrauterine infection caused by Candida during pregnancy is relatively rare; only 81 cases, all diagnosed after delivery, have been reported. We report six cases of candidal chorioamnionitis diagnosed by amniocentesis and confirmed by histologic studies, associated with preterm labor and delivery of five viable infants. Three of the six maternal patients had intrauterine contraceptive devices in situ. Three infants had a diagnosis of congenital cutaneous candidiasis and two had congenital systemic candidiasis, one with monilial pneumonia, and one with meningitis and septicemia. All viable neonates were treated successfully. The sixth, a very immature infant, died soon after delivery. Torulopsis (Candida) glabrata was isolated from this amniotic fluid. C. Albicans is a pathogen that potentially may cause chorioamnionitis and has been associated with high mortality (94%) in infants weighing less than 1500 gm. Use of amniocentesis in patients with preterm labor may allow early detection of subclinical candidal chorioamnionitis, thus guiding appropriate perinatal management.
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PMID:Candida chorioamnionitis diagnosed by amniocentesis with subsequent fetal infection. 371 42

Candida krusei colonized 12.4% of 868 patients undergoing episodes of therapy-induced granulocytopenia over a 9-year period. The gastrointestinal tract was most frequently colonized, followed by the respiratory tract and urinary tract. Ten patients developed systemic infections with C. krusei; all 10 had two or more positive blood cultures. Nine of the 10 patients were colonized with C. krusei, and 6 were receiving systemic antifungal agents at the time of development of the infection. Seven patients died within 1 month of C. krusei sepsis; systemic candidiasis was seen in the autopsies of the four patients on whom autopsies were performed. Therefore, C. krusei should be recognized as an emerging pathogen in select patient populations.
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PMID:Increased incidence of fungemia caused by Candida krusei. 377 46

Disseminated candidiasis occurring in heroin abusers has been reported in the recent years as a peculiar type of septicemia. Dermatological lesions consist of folliculitis with Candida albicans within hair shafts.
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PMID:Candida albicans septicemia with folliculitis in heroin addicts. 381 24

The clinical courses in 27 infants with culture or autopsy evidence of systemic candidiasis were reviewed. Twenty-two infants (group 1) had persistent signs of sepsis and clinical deterioration or died before institution of antifungal therapy. Five infants (group 2) improved markedly before culture results were reported, and recovered without systemic antifungal therapy. Fourteen infants in group 1 (64%) had central nervous system infection. Of four patients in whom CNS involvement was diagnosed only postmortem, antemortem cerebrospinal fluid from three was abnormal despite sterile cultures; no antemortem CSF was obtained in the other. In meningitis caused by susceptible organisms addition of flucytosine sterilized CSF within 5 days, although prior amphotericin monotherapy had been unsuccessful. Of 14 patients in group 1 who received systemic antifungal therapy, only one died with Candida infection. Toxicity from antifungal agents occurred in 11 of 13 successfully treated infants, but was reversible in every case except one by modifying the dosage. Our data indicate that (1) CNS infection is very common in infants with systemic candidiasis, (2) combined flucytosine-amphotericin therapy may facilitate treatment of CNS infection and should be the initial therapy for systemic candidiasis in infants, (3) Gram stains of CSF and urine enhance early diagnosis, (4) isolation of Candida from normally sterile body fluids in high-risk infants should be considered pathogenic and therapy initiated unless the clinical course strongly suggests otherwise, and (5) toxicity from antifungal agents is common but usually reversible.
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PMID:Systemic Candida infections in infants in intensive care nurseries: high incidence of central nervous system involvement. 648 39

Systemic candidiasis developed in a seven-week-old premature baby after 6 weeks treatment with antibiotics for suspected septicemia. At that time the echocardiogram showed a dense layer of echoes posteriorly to the anterior tricuspid leaflet during atrial systole. The diagnosis of Candida endocarditis with vegetations on the tricuspid valve and with right atrial thrombus secondary to the Candida infection was verified by autopsy.
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PMID:Echocardiographic diagnosis of Candida endocarditis of the tricuspid valve and of the right atrium in a young infant. 668 50

The incidence of candida septicemia in the neonatal period is increasing. We report a case of a preterm baby with acute anuric renal failure resulting from systemic candidiasis and we discuss of pathogenic factors, diagnosis and modern therapy. Prompt and opportune antimycotic therapy is the only chance for survival. The disease is generally fatal unless treated in time.
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PMID:[Candida sepsis in premature newborns]. 668

The clinical picture of 3 infants with systemic candidiasis who recovered spontaneously is described and a correlation is made between the clinical findings and laboratory data. The clinical picture is similar to that of 16 patients who died, some with septicemia of bacterial origin. The authors consider predisposing factors favoring the development of systemic mycotic infection such as: use of multiple antibiotics, continuous use of catheters, deficiency of IGA (in one patient). The diagnosis was suspected due to the prolonged course, the ill-defined toxic and infectious manifestations, the poor or lack of response to antibiotics and the negativity of bacterial blood cultures. The presence of Candida in various sites and cultures with positive serologic tests for Candida confirmed the diagnosis. Some considerations about antimycotic therapy are made and some circumstances that make the spontaneous cures of mycosis possible are considered.
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PMID:[Systemic candidiasis in the newborn. Report of 3 cases]. 698 53

Placental candidiasis is a rare condition; only 24 cases are reported in the literature. 3 additional cases are reported, 2 were associated with fetal cutaneous candidiasis and responded to administration of oral nystatin. Maternal vaginal cultures were positive in 1 of the 2 cases. In a 3rd case, systemic candidiasis was present. The child was delivered prematurely and died 90 minutes after delivery of severe respiratory distress. The mother had continuous vaginal candidiasis unresponsive to treatment throughout the pregnancy. In addition, an IUD was present. Other researchers have determined the criteria for Candida amniotic infection as: exclusive presence of Candida albicans in the different lesions, subacute or chronic specific lesions of fetal adnexae, and clinical manifestations in the newborn. The pathology of the placenta includes microscopic granulomata and presence of filaments or spores on the cord and histological change of the membrane or chorionic plate revealing intense chorioamnionitis with occasional focal granuloma. A review of the case reports indicates that 12 of the 27 infants were delivered after the 36th week and all but 1 were normal or recovered rapidly from cutaneous candidiasis. 15 of the 27 were delivered before the 36th week and only 1 survived. 6 were stillborn, and where histology was reported, systemic candidiasis was present. The 7 infants who died shortly after birth had Candida albicans. 1 infant was anencephalic. In only 5 cases did the membrane rupture more than 12 hours prior to delivery suggesting either Candida crosses the intact membrane or the possibility of a small leaking tear in the membrane. In 7 of the cases an IUD was present and the infection tended to be more overwhelming; all infants died from infection and septicemia, not complications of prematurity. The presence of the IUD is suspect for increased infection. The association of IUDs and Candida albicans-induced septicemia and fetal death warrants careful consideration of the advisibility of attempted removal of the IUD when Candida albicans is grown from the vaginal in the antenatal period.
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PMID:Placental candidiasis: report of three cases with a review of the literature. 709 25

Fungal infections of the heart are infrequent postoperative complications in children, yet, when present are often fatal. Children autopsied at The Johns Hopkins Hospital from 1889 to the present were studied for cardiac fungal infection. Among the 14 children so identified, 8 developed cardiac fungal infection after surgery. All postoperative cardiac infections were caused by Candida species. All were autopsied since 1959. Gastrointestinal surgery was performed in 6 patients and cardiac surgery in 2. Candida infection was not confined to the endocardium; endocarditis developed in 2 patients, pericarditis in 1, and myocarditis in 5. None received cytotoxic agents or corticosteroids. Two patients died from direct cardiac involvement. Other deaths were related to Candida sepsis or bronchopneumonia. A clinical diagnosis of cardiac fungal infection was never made. Prolonged administration of multiple antibiotics, central venous catheterization, prematurity and immune deficiency predisposed to cardiac and systemic candidiasis. Clinical features facilitating early diagnosis are discussed. Removal of central venous catheters infected with Candida did not eliminate the source of continued sepsis, since Candida-laden vegetations related to the catheter adhered to the superior vena cava and endocardial surface. Postoperative cardiac candidiasis is a relatively new and persistent problem of early diagnosis and therapy. The post-surgical pediatric patient has major predisposing factors for cardiac candidiasis, which, if unrecognized, may be a source for continued dissemination or may in itself be the cause of death.
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PMID:Postoperative Candida infections of the heart in children: clinicopathologic study of a continuing problem of diagnosis and therapy. 738 69


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