Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Whipple's disease is a systemic disease which may virtually affect any organ system, but in many cases it involves the small intestine causing gastrointestinal symptoms. The differential diagnosis is difficult since symptoms may be nonspecific. We report the case of a 44-year old white male patient with a history of migrating arthralgia and chronic fatigue. The patient newly developed an uveitis and underwent a vitrectomy; the further clinical work-up including gastroscopy with intestinal biopsy revealed no sufficient diagnosis. Subsequently, the patient's condition deteriorated with marked weight loss, fever and progressive weakness. An anaerobic sepsis with a corynebacterium was confirmed and with i.v.-antibiotics the patients's condition improved markedly. The further examinations disclosed enlarged mesenteric lymph nodes and the involvement of other organs (endocard, liver). CT-guided biopsy only showed fatty degeneration, but operative adenectomy confirmed Whipple's disease. The patient remained without relapse on long-term antibiotic treatment with doxycycline until today. Obviously, in our case the intestinal biopsies failed to detect Whipple's disease after the successful initiation of antibiotic treatment. In the absence of gastrointestinal findings and with concomitant secondary diseases the definitive diagnosis can be difficult. In addition, the previous uveitis and the endocardial involvement are most interesting.
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PMID:[Masked course of Whipple disease with uveitis, infection, endocardial involvement and abdominal lymphomas--case report and review of the literature]. 754 42

Acute pancreatitis, reported in 17% of pediatric patients with acquired immune deficiency syndrome (AIDS), is said to have a poor prognosis. We describe the pancreatic changes observed at autopsy from 71 children with human immunodeficiency virus (HIV) infection and document their nature, extent, and clinical relevance. The median age at autopsy of the children was 17 months (range, 2 months to 19 years); 38 were boys and 33 were girls. Parental intravenous drug use was the most frequent risk factor for AIDS, followed by blood transfusions. Respiratory failure and sepsis constituted the predominant causes of death. Nonspecific changes, such as edema, inflammation, fibrosis, inspissated material in acini and ducts, and enlarged Langerhans' islet predominated. Acute and chronic pancreatitis were mild except in one instance of a fatal acute probably dideoxyinosine-associated pancreatitis. Pancreatic involvement by opportunistic infections, such as cytomegalovirus (CMV), Mycobacterium avium intracellulare (MAI), and Candida, was focal and rare despite the high prevalence of these infections at autopsy. Focal lymphoplasmacytic infiltration and vascular calcifications were also observed. We conclude that pancreatic changes were frequently noted at autopsy in children with AIDS. They were usually mild, reflected systemic disease states, and were usually not life threatening. The incidence of opportunistic infections of the pancreas was low.
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PMID:Pancreatic disorders in pediatric acquired immune deficiency syndrome. 762 49

Sixteen dogs with splenic infarction due to causes other than splenic torsion were identified. Dogs with splenic infarction often had multiple concurrent diseases, and surgical management of splenic infarction was associated with high mortality. Splenic infarction occurred in dogs with hypercoagulable conditions associated with liver disease, renal disease, and hyperadrenocorticism, or as a consequence of uniform splenomegaly, neoplasia, or thrombosis associated with cardiovascular disease. Clinical signs and common laboratory findings generally reflected the underlying disease process. A variety of splenic abnormalities were detected by abdominal ultrasound in 15 dogs, with the ventral extremity of the spleen being most often abnormal. Four dogs were euthanized or died because of the presence of severe systemic disease, whereas 12 dogs underwent laparotomy. Complete splenectomy was performed in 9 dogs and partial splenectomy was performed in 2 dogs. Seven dogs died in the immediate postoperative period, 3 required chronic veterinary care, and 2 had uncomplicated long-term recoveries. Splenic infaraction should be regarded as a sign of altered blood flow and coagulation, rather than as a primary disease, and surgical management should be reserved for patients with life-threatening complications such as hemoabdomen or sepsis.
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PMID:Splenic infarction in 16 dogs: a retrospective study. 767 15

The medical records from 9 consecutive miniature horses (n = 5) and miniature donkeys (n = 4) with hyperlipemia (serum triglyceride concentration > 500 mg/dL) were reviewed. In all cases, hyperlipemia was a secondary complication of a primary systemic disease including septicemia, colitis, parasitism, esophageal obstruction, gastric impaction and rupture, fecalith, and pituitary adenoma. Therapy consisted of specific treatment for the primary disease, supportive care, and nutritional support. The mean time for resolution of hyperlipemia in cases requiring nutritional support (n = 6) was 7 days, and the duration of nutritional support in surviving patients was 11.7 days. Seven of 9 patients survived. The primary disease resulted in death in 2 patients. Enteral feeding with commercially prepared low residue diets and treatment of the primary disease was successful in reversing hyperlipemia in 5 of 6 surviving patients that required nutritional support. Parenteral administration of a glucose-based (non-lipid) solution was successful in resolving hyperlipemia in 1 patient.
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PMID:Hyperlipemia in 9 miniature horses and miniature donkeys. 783 16

The role of the genus Edwardsiella in human illness is reviewed. Of the three recognized species, only Edwardsiella tarda has been demonstrated to be pathogenic for humans. Chief infections associated with this species include bacterial gastroenteritis, wound infections such as cellulitis or gas gangrene associated with trauma to mucosal surfaces, and systemic disease such as septicemia, meningitis, cholecystitis, and osteomyelitis. Risk factors that are associated with E. tarda infections include exposure to aquatic environments or exotic animals (e.g., reptiles or amphibia), preexisting liver disease, conditions leading to iron overload, and dietary habits (e.g., raw fish ingestion). Although studies indicate that this bacterium is susceptible to most commonly prescribed antibiotics, fatal gastrointestinal and extraintestinal infections have been described.
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PMID:Infections associated with the genus Edwardsiella: the role of Edwardsiella tarda in human disease. 826 59

Locoregional expression of cat scratch disease is well known, but despite advances in microbiology over the last 10 years leading to the description of two new bacteria (Afipia felis, Bartonella henselae) the infective agent responsible for cat scratch syndrome remains unknown. Until the 80s, only one systemic disease was attributed to infection with a germ in the Bartonella genus: trench fever. With the onset of the AIDS epidemic, new clinical syndromes caused by Bartonella bacteria have been described: bacillary angiomatosis, hepatic peliosis, cases of recurrent septicemia, cases of endocarditis, etc. More recently, atypical forms of cat scratch disease including systemic diseases have been reported in immunocompetent subjects. Although quite rare (1% of the cases), such types of expression can raise questions as to diagnosis both in terms of clinical signs and in terms of bacteriological findings. Clinical and experimental data do not provide a clear direction for treatment but would suggest that prolonged use of aminoglycosides is useful.
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PMID:[Visceral localizations of cat-scratch disease in an immunocompetent patient]. 872 80

The present study outlines the relationship between cerebral and systemic hemodynamics in patients with septic shock. Sepsis is an immune mediated systemic disease in which the systemic vascular resistance (SVR) often decreases as a result of a Gram negative sepsis. The result is a hyperdynamic systemic circulation with redistribution phenomena in different organ systems. In order to study the effect of sepsis on cerebral vessels 20 patients with septic shock (12 men, 8 women, mean age 57.9 years) were subjected to both pulmonary artery catheter and transcranial Doppler (TCD) monitoring. The data were correlated to the APACHE II score and outcome. The study showed that cerebral mean and end-diastolic blood flow velocities (BFV) in the middle cerebral arteries significantly enhanced if the SVR-index decreases. In some patients a severely reduced SVRI (below 500 dynes.s/cm5.m2) was observed in combination with a downstroke latent steal phenomenon. TCD abnormalities were strongly related to disease severity and outcome. The increased BFV are explained by a mild vasospasm of the basal cerebral arteries. TCD appears to be a valuable tool to monitor the cerebral hemodynamics in these patients. They are particularly at risk for ischemic brain damage if they are subjected to therapeutic or spontaneous hyperventilation, which can potentially be detected by TCD.
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PMID:Transcranial Doppler and systemic hemodynamic studies in septic shock. 887 47

The objective of this study was to define the relationship between respiratory insufficiency (RI) and various putative risk factors for patients undergoing abdominal surgery. A review of 1332 adults undergoing abdominal surgery was undertaken. Information was collected in a unbiased, prospective and uniform manner with regard to baseline characteristics, perioperative events and adverse outcomes after surgery. Respiratory Insufficiency was defined as either: a PO2 < 60 mm Hg, the performance of a tracheotomy, or endotracheal intubation for more than 24 h. The incidence of RI was 3% (40/1332). A logistic regression analysis only identified an American Society of Anesthesia (ASA) classification > 2 (P < 0.001) and the presence of chronic bronchitis (P (P < 0.05) as significant risk factors. In addition, 33% (8/24) of the patients who developed postoperative intraperitoneal sepsis and 30% (14/47) of the patients who underwent a reoperation developed RI. It was concluded that patients with a significant systemic disease (ASA > 2), as well as patients with chronic bronchitis, should be the recipients of intense efforts to prevent pulmonary complications after abdominal surgery.
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PMID:Respiratory insufficiency after abdominal surgery. 943 29

Acute or chronic intestinal ischaemia can be the consequence of either intrinsic vascular disease, systemic disease, drugs or surgical procedures. In one quarter of the patients with intestinal ischaemia, no major vascular obstructions can be detected. Very rarely, the cause of ischaemia is splanchnic vasoconstriction due to cardiac arrhythmias or sepsis. The bowel becomes ischaemic as a result of underperfusion. The clinical picture resembles the one of occlusive intestinal ischaemia. From the pathological standpoint, the ischaemia is more intense on the antimesenteric border of the bowel an the lesions are more advanced in the mucosal than in the serosal layer. Often, the ischaemia involves other organs too: liver, spleen or gallbladder. The reconstructive vascular procedures are inefficient, the only therapeutical options remains the resection of the infarcted bowel, together with other organs involved in the ischaemia process. The mortality rate approaches 90%.
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PMID:[Nonocclusive intestinal ischemia]. 945 72

Acute or chronic intestinal ischaemia can be the consequence of either intrinsic vascular disease, systemic disease, drugs or surgical procedures. In one quarter of the patients with intestinal ischemia, no major vascular obstructions can be detected. Very rarely, the cause of ischaemia is splanchnic vasoconstriction due to cardiac arrhythmias or sepsis. The bowel becomes ischaemic as a result of underperfusion. The clinical picture resembles the one of occlusive intestinal ischaemia. From the pathological standpoint, the ischaemia is more intense on the antimesenteric border of the bowel and the lesions are more advanced in the mucosal than in the serosal layer. Often, the ischaemia involves other organs too: liver, spleen or gallbladder. The reconstructive vascular procedures are inefficient, the only therapeutical options remains the resection of the infarcted bowel, together with other organs involved in the ischaemic process. The mortality rate approaches 90%.
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PMID:[Nonobstructive intestinal ischemia]. 952 62


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