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

Epizootic outbreaks of red-sore disease in several reservoirs in the southeastern United States have been reported to cause heavy mortality among several species of fish having sport and commercial value. The etiologic agent is said to be the peritrich ciliate Epistylis sp.; secondary infection by the gram-negative bacterium Aeromonas hydrophila produces hemorrhagic septicemia which results in death. However, in recent studies on the largemouth bass Micropterus salmoides, Epistylis sp. could be isolated from only 35% of 114 lesions from 114 fish, while A. hydrophila was found in 96% of the same lesions. Transmission and scanning electron microscopy of lesions associated with red-sore disease indicate that neither the stalk nor the attachment structure of Epistylis sp. have organelles capable of producing lytic enzymes. Since other investigators have shown that A. hydrophila produces strong lytic toxins, and in absence of evidence to the contrary, it is concluded that Epistylis sp. is a benign ectocommensal and that A. hydrophila is the primary etiologic agent of red-sore disease.
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PMID:Ultrastruct of red-sore lesions on largemouth bass (Micropterus salmoides): associattion of the ciliate Epistylis sp. and the bacterium Aeromonas hydrophila. 10 85

The results of 97 autopsy cases of lymphogranulomatosis showed the causes of death to be either progression of the disease (78 cases), complications of treatment (12) or other diseases (7). The immediate causes of death in the progression of the disease were toxicity (29%), pulmonary insufficiency (22%), pulmonary-cardial insufficiency (12%), hepatic insufficiency (21%), peritonitis (3.4%), sepsis (5.8%), uremia (3.4%), posthemorrhagic anemia (1.7%), cerebral edema (1.7%). The immediate causes of death in complications of therapy were secondary infection (5 cases), posthemorrhagic anemia (3), pulmonary insufficiency (3), cerebral edema (1). In 7 observations death was not due to lymphogranulomatosis: in 2 cases it was caused by disseminated hematogenic tuberculosis, in 2 pneumonia (with cured lymphogranulomatosis, in 1 myocardial infarction, in 1 uremia (aterosclerotic nephrosclerosis) and 1 patient died accidentally.
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PMID:[Causes of death in lymphogranulomatosis]. 45 24

Pancreatic necrosis is a principal determinant of the severity, duration, and infectious complications of acute pancreatitis. There has been no objective index for pancreatic necrosis, and its recognition has necessarily rested upon nonspecific clinical signs, including later deterioration or appearance of sepsis. In search of such an index, we have measured serum levels of a poly-[C]-specific acid ribonuclease (RNase) in 38 patients with acute pancreatitis, 12 patients with chronic pancreatitis, and 50 control patients. The values in chronic pancreatitis (mean, 52 units; range, 33 to 80 units) were within observed normal limits (mean, 51; range, 17 to 94). The values in acute pancreatitis segregated into two groups, normal values (group A) and high values (group B). Of 25 patients in group A (mean, 46; range, 19 to 87), only one developed evidence of pancreatic necrosis or abscess. In contrast, of the 13 patients in group B (mean, 192, range, 98 to 385), 11 required surgical debridement/drainage for pancreatic necrosis (six) or abscess (five) (P less than 0.001). Each of the other two patients had prolonged pancreatic inflammation with fever and a pancreatic mass which persisted for more than 2 weeks. RNase levels in group B patients rose within a few days after onset of pancreatitis and tended to parallel the clinical course. These findings suggest that measurement of serum RNase in acute pancreatitis gives a reliable indication of pancreatic necrosis. Therefore RNase determinations should be of value for earlier identification and monitoring of patients at high risk of late complications, and for helping to select those who will benefit from early debridement before secondary infection occurs.
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PMID:Serum ribonuclease elevations and pancreatic necrosis in acute pancreatitis. 46 72

The spread of group A streptococcal infection to close contacts of infected persons is well recognized. With the resurgence of invasive group A streptococcal infections, there is an increased potential for clusters of patients with invasive disease. We reviewed data collected since December 1988 at the Centers for Disease Control (Atlanta) to identify clusters of infection in which one or more patients had invasive disease. Twelve family clusters were identified. Infection in index cases included the toxic shock-like syndrome and septicemia. Infection in family contacts included invasive infections, pharyngitis, or asymptomatic carriage. Most invasive disease occurred in adults, while the majority of noninvasive infections were in children. Five nosocomial clusters with spread of infection from patients to hospital personnel were documented. All index patients had the toxic shock-like syndrome; secondary infections included the toxic shock-like syndrome, pneumonia, bullous cellulitis, lymphangitis, and pharyngitis. Clusters of invasive infections also were identified in five nursing homes. Pneumonia, cutaneous infections, and the toxic shock-like syndrome occurred most commonly. Clustering by nursing home unit occurred in three outbreaks. In hospitals and nursing homes, improved infection control will likely decrease secondary spread; in families, spread of disease may be prevented by identifying and treating those harboring the organism or by chemoprophylaxis. Studies that characterize the rate of secondary infection are needed before definitive recommendations can be made.
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PMID:Clusters of invasive group A streptococcal infections in family, hospital, and nursing home settings. 152 Jul 63

Two cases of serious infection following catfish spine-related injuries are presented, and the literature on this topic is reviewed. The organisms usually involved in such infections are Vibrio species, Aeromonas hydrophila, Enterobacteriaceae, Pseudomonas species, and components of the flora of the human skin. Irrigation, exploration, and culture of these wounds as well as immunization of the patient against tetanus are recommended. Patients with hepatic disease or chronic illness and immunocompromised individuals are at unusually high risk of fulminant infection due to Vibrio and Aeromonas species and should be treated with antibiotics after sustaining a water-associated wound. Patients with normal host defense mechanisms but with late wound care, punctures involving a bone or a joint, progressive inflammation hours after envenomation, fever, or signs of sepsis are at high risk for secondary infection and should receive definitive wound care and antibiotics. For moderate to severe infections, one of the following combinations constitutes a reasonable empirical regimen: (1) a tetracycline and a broad-spectrum, beta-lactamase-stable beta-lactam antibiotic, or (2) a tetracycline, a beta-lactamase-stable penicillin, and an aminoglycoside.
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PMID:Catfish-related injury and infection: report of two cases and review of the literature. 156 61

We prospectively studied newborn infants with sepsis and neutropenia who were randomly selected to receive standard supportive care and either adjuvant granulocyte transfusions or intravenous immune globulin (IVIG) infusions; 21 infants received granulocyte transfusions and 14 received IVIG infusions. Half of the patients were premature (gestational age less than or equal to 32 weeks); the average postnatal age was 5 days (range 3 to 8 days). All infants had neutropenia by the criteria of Manroe et al., and the mean average bone marrow neutrophil storage pool ranged between 35% and 37%. There were no significant differences with respect to serum IgG, IgA, IgM, and total hemolytic complement values between treatment groups or between survivors and nonsurvivors. Clinical severity as defined by hypoxia, acidosis, and hypotension was similar between treatment groups. Group B streptococcus was the most common organism identified and accounted for almost 33% of all bacterial isolates. There was a significantly different survival rate in the group receiving polymorphonuclear leukocyte transfusions (100%, 21/21) compared with the group receiving IVIG infusions (64%, 9/14; p = less than 0.03). There were no significant complications in either treatment group with respect to fluid overload, secondary infection, blood group sensitization, pulmonary complications, or graft-versus-host disease. This pilot study suggests a possible benefit of granulocyte transfusions compared with 'IVIG therapy in the adjuvant treatment of neonatal neutropenia and overwhelming bacterial sepsis.
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PMID:Randomized trial of granulocyte transfusions versus intravenous immune globulin therapy for neonatal neutropenia and sepsis. 151 35

Since 1980, numerous reports have been published throughout the world on the pathogenic role of Branhamella catarrhalis. Apparently, Branhamella infections have been increasing in many places. Although they can affect various organs, they are most commonly observed in the airways and eye (both in children and adults). Not infrequently, Branhamella catarrhalis causes sepsis, in particular in immunosuppressed patients. The rapid increase in beta-lactamase-forming Branhamella strains results in frequent ineffectiveness of treatment with penicillin. In patients treated with penicillin for a primary infection by other bacteria, a secondary infection due to penicillin-resistant Branhamella organisms can subsequently occur. For treatment, therefore, beta-lactamase-stable antibiotics should be preferred.
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PMID:[Branhamella catarrhalis as a disease pathogen]. 193 24

Without surgical debridement in patients with infected pancreatic necrosis, survival can not be expected. Previous surgical series reported postoperative survival in the range of 50%; however, more recent reports demonstrate improved mortality of 10% to 20%. Despite the demonstrated advances in surgical management, much remains to be done. Ongoing sepsis and the multiorgan failure syndrome (including ARDS, renal, and hepatic failure) are frequently part of the terminal phase of necrotizing pancreatitis, and further declines in mortality await future improvements in supportive therapy for overwhelming sepsis. Finding a means to prevent secondary infection of necrotizing pancreatitis would also have a very significant impact on survival. Defining the various form of severe acute pancreatitis and its infectious complications by dynamic pancreatography and CT-directed aspiration will permit meaningful trials of new methods to treat these unfortunate patients.
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PMID:Current management of pancreatic abscess. 199 28

The anatomy and management of 16 female patients with urorectal septal defects have been reviewed. The diagnosis was often confused by the anomalous appearance of the external genitalia, and the internal arrangements of the urinary tract, genital tract and lower intestinal tract were frequently bizarre and unpredictable. Because of the potential of these patients for secondary infection and sepsis, a prompt and thorough anatomical evaluation in such cases is essential. Initial treatment should be directed toward decompression of the involved organ systems and definitive reconstruction should be deferred until the child is older, at which time the emphasis should be upon a simultaneous multisystem repair performed, whenever possible, in 1 stage.
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PMID:Cloacal anomalies and other urorectal septal defects in female patients: a spectrum of anatomical abnormalities. 201 86

Since its first description in 1967, the mortality of the adult respiratory distress syndrome (ARDS) has remained unchanged despite the increasing sophistication of supportive techniques. Few patients now die of refractory hypoxemia, the majority succumbing to the multiple systems organ failure syndrome, commonly due to sepsis. Sepsis is both the most common cause of ARDS, usually involving the abdomen, and the most frequent complication, usually affecting the lungs. ARDS is, thus, increasingly seen as the pulmonary component of multiple systems organ failure, triggered by the systemic response to sepsis. In critically ill patients, impairment of hepatic function and of the barrier function of the gut mucosa allows translocation of endotoxin derived from the aerobic Gram-negative bacteria within the gut. This releases mediators which are responsible for the activation of cellular and humoral cascades, resulting in the pathological changes seen in ARDS. This sequence of events underlines the importance of therapies directed at abnormal colonization of the gastrointestinal tract and elimination of the gut endotoxin pool. Selective decontamination of the digestive tract is attractive in that it attacks the problem from 2 sides: first, by eliminating colonization, it appears effective in preventing secondary infection and, second, it may also play a role in reducing the enteric endotoxin pool. Recent descriptions of pathological oxygen supply dependency in both ARDS and septic patients emphasize the similarity of pathophysiological abnormalities in the 2 conditions. Intensive supportive therapy to achieve adequate oxygen transport and aggressive investigation and surgical management of septic foci are the cornerstones of management of the established syndrome.
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PMID:Intraabdominal infection: pulmonary failure. 218 82


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