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

Haemophilus influenzae type b is a human bacterial pathogen that causes approximately 12,000 cases of H influenzae type b meningitis and 7500 cases of other forms of invasive disease annually in the United States. This organism is the leading cause of bacterial meningitis in the United States. The cause of meningitis can be established more accurately than that of other forms of invasive bacterial disease because the isolation of the bacterium from the cerebrospinal fluid or blood and/or the detection of bacterial antigen can correctly attribute the infection to a specific bacterial agent and dictate appropriate antimicrobial therapy. In children, more than 95% of all invasive diseases attributable to Haemophilus species, including septicemia, pneumonia, epiglottis, cellulitis, arthritis, osteomyelitis, and pericarditis, are due to H influenzae type b. It has been estimated that systemic disease caused by H influenzae type b occurs in approximately 1 in 200 children in the United States before the age of five. The case fatality rate for H influenzae type b meningitis is approximately 5%, and substantial morbidity has also been documented to result from central nervous system infection with this agent. Of surviving children reported in a 1969 paper, 40% had significant neurologic sequelae after meningitis. A more recent study demonstrated substantial neurologic improvement during the first few months after hospitalization, but at 1 year of age 8% of the children had neurologic or intellectual sequelae of their meningitis. Milder defects with an array of developmental problems have been reported in as many as one third to one half of all survivors.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Epidemiology of Haemophilus influenzae type b infections. 217 52

We have discussed the relationship between systemic illness, infection, and lung disease. As we have seen, patients with a wide variety of disease states, including advanced age, diabetes mellitus, alcoholism, collagen vascular disease, cancer, heart failure, and organ transplantation are potentially at increased risk for pneumonia because of disease-related impairments in host defenses. In addition, two virtually ubiquitous conditions in hospitalized patients, malnutrition and therapeutic interventions (especially with common medications), frequently add to the risk of airway invasion by bacterial pathogens. Systemic illness not only makes lung infection more common, but may adversely affect outcome and resolution, as well as determine the clinical presentation of pneumonia. In one particular population, the intubated and mechanically ventilated patient, the risk of infection is particularly high, and nosocomial pneumonia is a major cause of mortality. To the extent that the host response itself leads to the symptoms and signs of infection, systemically ill individuals may have subtle clinical features when serious bacterial invasion is present. Many components of the host defense system can become abnormal with serious illness, but a common mechanism that ties many systemic diseases to pneumonia is an alteration in airway epithelial cell receptivity for bacteria, namely, bacterial adherence, a process that mediates airway colonization, the first pathogenetic step on the road to pneumonia. The impetus for understanding how serious illness promotes lung infection is that once these mechanisms are identified, potential preventative strategies to minimize infection risk in the individual with systemic disease may be developed. The relationship among systemic illness, the lung, and infection also exists in a different direction: infection of a systemic nature (the septic syndrome) can lead to disease in the lung (ARDS). We have described the features of the septic syndrome and identified how it may lead to lung injury, usually by indirect means, through activation of inflammatory mediators that are carried to the lung via the vasculature. Although it is frequently impossible to predict which specific patient with systemic sepsis will develop acute lung injury, the current state of knowledge does permit us to identify high-risk individuals. Surprisingly, clinical assessment rather than biochemical testing is the best predictor of the development of acute lung injury. Patients with severe injury, profound shock and multiple systemic insults are most prone to acute lung injury in the presence of systemic sepsis.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Respiratory infections and acute lung injury in systemic illness. 268 63

Clostridia septicemia has traditionally been associated with severe histocytotoxic infections. Recently, due to better anaerobic culture techniques, clostridia bacteremia is seen with increasing frequency in patients without an obvious source of infection. The authors reviewed their experience with 29 patients with clostridia bacteremia. The overall mortality rate was 45 per cent. No obvious source for the clostridia bacteremia was identified in 21 patients (72%). Eighty-three per cent of the patients had polymicrobial infections. The patients were generally debilitated with significant associated systemic disease. Antibiotic therapy did not appear to have any effect on mortality. Patients with asymptomatic clostridial bacteremia are, in general, patients with advanced malignancies and chronic illnesses. Antibiotic therapy appears to have little effect on the patient's outcome.
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PMID:Clostridium perfringens bacteremia. Opportunist or killer? 285 23

Genetic diversity and relationships among 63 isolates of Escherichia coli from infants in Finland with septicemia or meningitis were assessed by analyzing electrophoretic variation in 21 enzymes encoded by chromosomal genes. Thirty-nine multilocus genotypes (electrophoretic types) were distinguished, 23 of which formed a closely related, distinctive subset (group 1) of five or six clones represented by 40 (63%) of the isolates. The remaining isolates represented a second subset of 16 electrophoretic types (group 2) that were, on the average, rather more distantly related to one another. Although the number of electrophoretic types causing neonatal systemic disease is smaller than that occurring in healthy intestinal floras, the pathogenic electrophoretic types are only slightly less diverse genetically. Isolates of group 1 were characterized by relatively high incidences of hemolysin production and S, type 1, type 1C, and P fimbriae. However, because phenotypic characters, considered individually or in combination, did not adequately reflect the overall genetic relationships of isolates, it is recommended that the genetic structure of populations be defined on the basis of multilocus chromosomal genotypes.
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PMID:Genetic relationships and clonal structure of strains of Escherichia coli causing neonatal septicemia and meningitis. 287 26

Scleromyxedema is a rare fibromucinous connective tissue disorder characterized by papular skin lesions associated with sclerosis and a serum monoclonal gammopathy. Little is known about either the natural history or the systemic manifestations of this disease. We reviewed the medical records of 19 patients with biopsy-proven scleromyxedema seen from 1950 to 1985 for evidence of systemic disease. There were 10 males and 9 females with a median age at diagnosis of 53 years. Monoclonal gammopathy was present in 13 patients. Eight patients complained of dysphagia; 3 had proximal esophageal dysfunction and 1 had total esophageal aperistalsis on barium swallow. Proximal muscle weakness was noted in 5, with an inflammatory myopathy in 3. Six patients complained of dyspnea on exertion. Of these, 5 had reduced diffusing capacity, 3 had reduced volumes, and 2 developed cor pulmonale. Pathologic changes characteristic of "scleroderma kidney" were demonstrated in 1 patient at postmortem. One patient had Raynaud's phenomenon and 2 had arthralgias/arthritis with noninflammatory synovial fluids. Although 8 of 12 patients treated with melphalan noted regression of their skin changes, no consistent improvement in the extracutaneous manifestations was demonstrated. Furthermore, 2 patients died of sepsis related to melphalan-induced myelosuppression, and 4 developed hematological malignancies following melphalan therapy. In conclusion, systemic manifestations in scleromyxedema are more prevalent than previously recognized, and can resemble those of scleroderma. Significant toxicity occurred with the use of alkylating agents in these patients, with treatment-related complications developing in 45% of patients treated with melphalan. The lack of definitive data regarding the natural history of this disease complicates the question of optimal therapy, but the use of alkylating agents should be reserved for those patients with severe debilitating skin disease.
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PMID:Scleromyxedema: a scleroderma-like disorder with systemic manifestations. 333 81

The results of arthroplasty of the hip and other surgical procedures that were performed in nine patients who had sickle-cell disease or sickle-cell trait and osteonecrosis of the femoral head were not very satisfactory. After an average duration of follow-up of 6.5 years (range, two to 25.7 years), the complications were many and severe. Of eight arthroplasties that were done for replacement of a joint, five required early revision or excision: two, because of mechanical loosening; two, because of sepsis; and one, due to a fracture of the prosthetic stem. There was excessive perioperative blood loss, prolonged hospitalization, and medical or surgical complications in all patients, including the three who had sickle-cell trait and only slight manifestations of systemic disease. A survivorship analysis of this series indicated that a failure rate of 50 per cent could be expected by 5.4 years postoperatively.
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PMID:Osteonecrosis of the hip in the sickle-cell diseases. Treatment and complications. 335 16

One case of deep sepsis from Mycobacterium tuberculosis occurring two years after total hip replacement is reported. The patient had no history of previous tuberculous infection nor showed any sign of systemic disease at the time of surgery. The clinical and pathogenic implications are discussed.
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PMID:Deep sepsis from Mycobacterium tuberculosis after total hip replacement. Case report. 338 40

Between 1980 and 1982, 233 patients were treated for anorectal sepsis in three hospitals. The incidence of underlying disease associated with perianal sepsis and the results of surgical treatment were assessed retrospectively. Of the 233 patients who had perianal sepsis, 136 (58.4 percent) had perianal abscesses, while a further 12 (5.1 percent) had associated fistulas. Ischiorectal abscesses were found in 79 (33.9 percent) and a further two (0.9 percent) had fistulas. Four (1.8 percent) patients were found to have intersphincteric abscesses. One hundred and nine (46.8 percent) had examinations under anesthesia or definitive procedures, while the remaining 124 (53.2 percent) had incision and drainage alone. A second procedure was required by 55 (23.6 percent) patients, 40 (32 percent) in the group who had incision and drainage only and 15 (14 percent) of those having initial examinations under anesthesia (P less than .001). Twenty-seven (11.6 percent) patients had occult disease. Twelve patients (5.1 percent) had systemic disease (six diabetic, three nongastrointestinal neoplasia, two inflammatory, and 1 hematologic), while of the 109 patients who had examinations under anesthesia, 15 (6.4 percent) had associated colorectal pathology (four neoplasia, 11 inflammatory). It is important that patients with anorectal sepsis have complete medical and surgical assessments at the time of their first admission.
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PMID:Anorectal sepsis as a presentation of occult rectal and systemic disease. 340 85

Sepsis is a systemic disease caused by pathogenic microorganisms and their toxic products in blood. Very often it is not possible to identify the pathogenic organisms before therapeutic treatment. Thus, diagnosis has to be made based on the patients' disposition as well as clinical symptoms. In septic patients clear alterations of plasma protein fractions are found. Depending on the clinical degree of severity, the low molecular proteins, detectable by column chromatography in plasma fraction III, are considerably increased. Population of implanted synthetic materials (such as catheters and cardiac valves) with facultative pathogenic microorganisms that may persist under antibiotic influence due to extracellular polymeric substances, is also of great importance. Therapy with antibiotic combinations is the most important therapeutic principle for sepsis and can be intensified by simultaneous administration of immunoglobulins.
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PMID:[Nosocomial infection]. 361 Feb 8

Arthrodesis remains the procedure of choice for salvage of an infected total knee arthroplasty in patients with relatively minor preprosthetic arthroplasty disability. Patients with very severe preprosthetic disability resulting from multiarticular disease or other systemic disease may be treated best by a resection arthroplasty. Systemic sepsis can be eliminated in almost all patients, and drainage can be eliminated in most. Those patients who find the stability of a resection arthroplasty inadequate for their needs can have a secondary arthrodesis performed with an intramedullary rod, which yields a high probability of success. External immobilization is not necessary. The advantages of a two-stage arthrodesis are that it is an elective procedure, performed in a limb free of sepsis. The patient has been psychologically prepared for the arthrodesis, and the two-stage procedure has a high probability of success. Neither the underlying diagnosis, nor the infecting organism, nor the type of infected prosthesis is a reliable predictor of success or failure of either a resection arthroplasty or a second-stage arthrodesis.
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PMID:Resection arthroplasty: an alternative to arthrodesis for salvage of the infected total knee arthroplasty. 381 15


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