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

It was established that septic shock is a rare (0.2%) but the severest (5 of 6 patients died) complication in pulmonary surgery and is a consequence of the spread of postoperative wound infection or pyo-inflammatory process in the lung for which the operation was performed. The staphylococcus and nonfermentative Gram-negative bacteria prevail among the causative agents of septicemia. The most typical clinical signs of septic shock are acute circulatory insufficiency with rapid development of insufficiency of the function of the brain, kidneys, liver, and intestinal paresis in a febrile patient with a severe postoperative wound infection or in one operated on for a disseminated pyo-inflammatory disease in the lung. Precise determination of the indications for operation, careful preoperative treatment of the pyo-inflammatory processes, immediate establishment of the diagnosis, and timely removal of the localized focus of infection are important in preventing septic shock.
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PMID:[Several aspects of septic shock in lung surgery]. 274 8

The possible infections of 43 hospitalized patients with systemic lupus erythematosus (SLE) has been assessed. Out of the 43 patients 17 had some type of infection (41%). The diagnosis was proven by positive cultures in 84% of the cases. Urinary infections due to E. coli were the infections most commonly found. Four infections due to staphylococcus, 2 to S. typhi and 2 to invasive Aspergillosis were also found. Tuberculosis was observed only in 2 patients. In twelve out of the 17 patients with infections, SLE was active and 10 of the latter had renal failure. In addition to the 18 urinary infections diagnosed, sepsis was encountered in 5 patients and pneumonias in 4. Only two infected patients died (those with invasive aspergillosis). Thus, infections are frequent in patients with SLE and precise diagnosis often requires positive culture test.
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PMID:[Infection in systemic lupus erythematosus]. 277 94

In a retrospective study some epidemiologic and clinical aspects of 247 sepsis episodes observed during the period 1983-88 in the Medical Department of Locarno District Hospital are analyzed. 61% of the 233 patients were aged over 70 and 48% had one or more underlying diseases predisposing them for infection. The commonest sepsis pathogens were gram-negative bacilli (59% of all isolates), followed by pneumococci (15%) and staphylococci (14%). Over 99% of gram-negative pathogens were sensitive to gentamicin, 92% to ceftriaxone. 78% to amoxycillin clavulanate, 74% to cotrimoxazole and 59% to ampicillin; 19% of staphylococcus strains were methicillin-resistant. The most frequent sites of entry for the pathogens were urinary tract (39% of all episodes), the lower respiratory tract (22%) and the gastrointestinal tract (12%). Infection-related mortality was 9% and total hospital mortality 18%. The least favourable prognostic factors were severity of the underlying disease, initial circulatory shock and pulmonary localization of infection (especially where the causative agents were other than pneumococci).
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PMID:[247 episodes of sepsis at a medical department of a district hospital]. 279 46

Discitis is a rare complication of disc operation. The incidence rate varies from 0.2 to 0.8% according to the series. During a 6 year period (1980-1986) 1,796 patients were operated for lumbar disc protrusion at our institution and twelve of them (0.66%) developed a post operative discitis. Bacteriologic verification due to the infection was ascertained in ten cases. Direct contamination during surgical time is likely far more frequent than hematogenous contamination because the liable germ was staphylococcus in 9 cases. Ascertaining the diagnosis is base upon clinical picture and some selected investigations. It may be earlier than it has been said before. Discitis may be suspected within a week after operation in two cases out of three. The most prominent clinical feature is back pain with muscle spasm but sometimes diagnosis may be misled to a psychiatric condition or a visceral disorder. Among conclusive investigations we range in the first place the needle aspiration of the disc which permitted to isolate a germ nine times out of eleven. Next the bone scan with H.M.D.P. Te 99 (8 Mbq/kg) which revealed a significant uptake pattern in eight cases out of eight. Finally the blood culture which grew five times out of ten. Risks of discitis, i.e septicemia, polysegmental infection or death justify in our opinion an appropriate antibiotherapy during at least 8 weeks. Moreover, in our experience, it is the best antalgic treatment that we can offer and back pain decreases as soon as the second day with antibiotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Spondylodiscitis after surgery of lumbar disk hernia. Apropos of 12 cases in 1796 operations]. 307 Apr 22

We report our experience with coagulase-negative staphylococcal infection over a period of 1 year. The incidence of coagulase-negative staphylococcus septicemia was 4.25% (13 newborn infants) of the 306 admissions to our Neonatal Intensive Care Unit. Ten patients (76.9%) were premature infants. Four infants in our series were less than 48 h of age. Two of these were presumably born with the infection. Six infants had involvement of the lungs. The strains of coagulase-negative staphylococci cultured from all cases of neonatal septicemia were sensitive to cephalothin, but were considerably less sensitive to the currently used antibiotic combinations. Our observations indicate that coagulase-negative staphylococci must be suspected in early or late neonatal sepsis, and that early antibiotic treatment by cephalothin may prevent morbidity.
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PMID:Neonatal septicemia caused by coagulase-negative staphylococci. 308 96

Sixty-seven cases of total arthroplasty of the hip in the presence of sepsis performed between 1974 and 1986 were reviewed. These prostheses were inserted in 57 cases to replace septic prostheses. Forty-six were infected total hip prostheses and 11 were infected head and neck replacement femoral prostheses. In 10 cases arthroplasty was performed for subacute septic arthritis, usually secondary to trauma. In seven cases, a simple revision of the prosthesis by excision and lavage of infected tissues was performed. In 51 cases, a total hip replacement arthroplasty was performed in one stage. When one of the components was not loose it was preserved; in 17 cases the femoral cement was retained and in six the acetabular cup was retained. In eight cases, the prosthesis was removed, excision of the tissues was made and a total hip arthroplasty inserted after a minimum interval of six months. As regards infection, success was achieved in 69 per cent of cases rising to 85 per cent after secondary removal of the prosthesis. In relation to function, a good or fair result was achieved in 72 per cent of cases. The results were favourable in 81 per cent of cases with complete exchange of prostheses and in 75 per cent with preservation of the femoral cement. Preservation of the acetabular cup was only successful in 40 per cent of cases. Accessory factors in the prognosis were the addition of a bone graft, which became incorporated in 29 cases out of 30 and the nature of the organism which was of no significance, except that staphylococcus epidermidis and Koch's bacillus proved to be more easy to treat.
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PMID:[Total hip arthroplasty in the presence of sepsis]. 317 4

Among 829 consecutively treated neonatal intensive care patients during the years 1985 and 1986 46 cases of early onset type an 14 cases of late onset type (beyond the 4th day of life) of sepsis neonatorum were diagnosed. Mortality was 20%. In 40% of the cultures penicillin-resistant staphylococcus epidermidis was found. It was resistant to Penicillin however fully sensitive to Cefamandol, Netilmycine and Amicacine. Primary therapy of early onset type of sepsis has to be effective against Streptococci and against Listeria monocytogenes. Blood culture is the only way to proove or to exclude sepsis at a rational way. Good hospital hygiene can prevent a part of late onset type of sepsis. Immuntherapy is regarded as an import part of Sepsistherapy in the newborn.
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PMID:[Observations on neonatal infection]. 318 65

After out of hospital CPR thirty three resuscitated patients were studied for bacteremic complications. Thirteen patients (39%) had two or more positive blood cultures during the twelve hours following CPR. Source of superinfection was a central venous catheter in one case (staphylococcus). The twelve other bacteremic patients had fetid diarrhea a few hours after admission. The same organism were found in blood and faeces (streptococcus D, Escherichia coli, Pseudomonas aeruginosa, acinetobacter, enterobacter). Mesenteric ischemia caused by a low cardiac output may explain the diarrhea and the intestinal origin of the septicemia. All patients (12 cases) with diarrhoea and bacteremia died. Patients who recovered without neurologic sequelae (4 cases) had never been septic and never had diarrhea.
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PMID:Bacteremia following cardiac arrest and cardiopulmonary resuscitation. 322 Oct 11

Five patients with infected abdominal aortoiliac aneurysms were treated. The diagnosis was made preoperatively based upon fever, leukocytosis, positive blood culture findings, and presence of an aneurysm in all five patients. Two patients had salmonella species, two had staphylococcus species, and one had bacteroides species cultured from the blood and aneurysm contents. All patients were treated with appropriate antibiotics and a single operative procedure consisting of preliminary extraanatomic bypass followed by complete aneurysm excision and posterior drainage of the retroperitoneum. There were no operative deaths and no instances of aortic stump disruption, persistent retroperitoneal sepsis, or graft thrombosis. All patients were alive and well on last follow-up 15 months to 5 years postoperatively.
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PMID:Treatment of infected abdominal aneurysms by extraanatomic bypass, aneurysm excision, and drainage. 336 20

The complications associated with the insertion and use of 95 single lumen and 312 double lumen Hickman right atrial catheters in 357 marrow transplant recipients were retrospectively analyzed. Three-hundred (84%) first inserted catheters were in place for a median of 93 days (range, 16-209) without complications and were removed electively. Thirty-nine (9.6%) of all catheters were removed for infections and 24 (5.9%) for mechanical complications. Ninety-five patients (26.6%) had 111 episodes of septicemia involving 128 separate organisms and 25 patients had 25 episodes of localized catheter infection with 26 separate organisms. The most frequently isolated organism was coagulase-negative staphylococcus. Twelve of 24 removals due to mechanical complications were caused by accidental pulling of the catheter by the patient.
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PMID:Hickman catheter complications in marrow transplant recipients. 351 20


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