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

CRP levels have been found to be helpful in differential diagnosis and in following the clinical course and response to treatment of various disorders. Of particular interest is their value in the diagnosis of serious bacterial infections in neonates, such as meningitis, septicemia, and osteomyelitis. While no individual has been reported to be deficient in CRP, it is possible that abnormalities of CRP synthesis and function will be found. As increasing knowledge of the role of CRP accumulates, it is conceivable that CRP may acquire some therapeutic value. Increasing availability of rapid quantitative methods for CRP is likely to result in greater clinical usefulness.
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PMID:C-reactive protein in pediatrics. 636 43

Ceftazidime ( CAZ ), a new injectable cephem antibiotic, was used for treatment of infections in children, and the following results were obtained. After an intravenous injection of CAZ at a dose of 20 mg/kg, the mean blood levels in 2 patients were 41.5 micrograms/ml at 30 minutes, 18.1 micrograms/ml at 2 hours and 2.55 micrograms/ml at 6 hours, with the half-life (T 1/2) of 1.37 hours. In a 22-day-old baby with meningitis given CAZ intravenously at a dose of 43.5 mg/kg, the blood levels were 100 micrograms/ml at 30 minutes, 68 micrograms/ml at 2 hours and 25 micrograms/ml at 6 hours, with the half-life (T 1/2) of 2.96 hours. After intravenous administration of CAZ in doses ranging from 35.7 to 50 mg/kg, CSF concentrations ranged from N.D. to 6.3 micrograms/ml in 3 patients with purulent meningitis, although 19 micrograms/ml at 1 hour and 13 micrograms/ml at 2 hours in 1 patient after intravenous administration of 46.7 mg/kg. In patient with mumps meningitis, CSF concentrations were undetectable after intravenous administration of 35.7 mg/kg. Seventeen patients (each 1 patient with lymphadenitis, tonsillitis and septicemia, each 2 patients with pneumonia, bronchiectatic bronchitis, pyothorax and purulent meningitis, each 3 patients with pyelonephritis and enteritis) were treated with CAZ intravenously, at the daily doses of 178.2 mg/kg and 200 mg/kg in 4 divided doses in patients with meningitis and 44.1 to 103.4 mg/kg in 3 divided doses in patients with other infections (two of them were given by intravenous drip infusion for 30 minutes). The clinical responses were excellent or good in all the patients except for 1 case of Salmonella enteritis (poor) and 1 case of Campylobacter enteritis (poor). The efficacy rate was 88.2%. It was noteworthy that the clinical response was excellent in 1 case of septicemia with P. aeruginosa with leukemic stage of malignant lymphoma and in 2 cases of purulent meningitis. As side effects, fever, eruption, leukocytopenia, elevation in GOT and positive CRP considered to be allergic, were observed on day 16 of administration in 1 case of pyothorax. These symptoms disappeared by discontinuance of administration. In addition, there were elevation in GOT and GPT in 2 cases and elevation in GOT in 2 cases and elevation in GPT in 1 case; they were all mild or transient, and there was nothing to be worried about.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Clinical evaluation of ceftazidime in paediatrics]. 637 60

A case of toxic-shock syndrome due to Streptococcus pyogenes is reported. A 76-year-old female was admitted with complaints of fevers and chills. She had been suffering from cellulitis on her right dorsum pedis for 7 months. Laboratory data on admission showed elevated values of WBC, CRP, and dysfunction of the liver and kidney. She was diagnosed as sepsis due to the cellulitis, and was treated with PIPC and FMOX. However, several hours after admission, her blood pressure decreased and oliguria appeared. Bacteriological examinations from the blood and the cellulitis revealed group A beta-hemolytic Streptococcus which gave streptococcal pyrogenic exotoxin (T-28, SPE.B + C). She died 23 hours after her admission in spite of changing antibiotics to a high-dose of PC-G therapy. This is one of the rare cases of toxic shock-like syndrome due to Streptococcus pyogenes from the cellulitis of the dorsum pedis.
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PMID:[A case of toxic shock-like syndrome due to Streptococcus pyogenes]. 759 93

The prognosis of an individual attack of acute pancreatitis is dependent on its severity and whether or not sepsis develops in or around the pancreas. Approximately 20-25% of patients with acute pancreatitis have a severe form of the disease which usually necessitates high dependency or intensive care management in the first week or two of illness. While most of these patients can readily be identified by experienced clinical judgement a proportion of them do not appear unduly ill at first presentation. For this reason a number of objective grading systems have been devised which identified the group of patients with the greatest likelihood of developing major complications and being at risk of death. The most commonly utilised systems in the United Kingdom are the eight factor Glasgow scoring scale and the APACHE II system. The measurement of C-reactive protein is also helpful and it has recently been shown that the combining of the Glasgow scoring system with CRP results in 80% or better sensitivity and specificity for those who develop major clinical complications. The body mass index (BMI) when over 30 kgs/m2 is also a useful marker of an adverse outcome, and CT scanning is another method of grading severity. The newer markers of interleukin 6 and PMN elastase have yet to be proved in a large prospective clinical study but do show considerable promise as being of value in identifying the patient at risk.
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PMID:Prognosis of acute pancreatitis. 766 94

In a prospective study, the diagnostic value of C3d serum levels was compared with that of neutropenia, hyperfibrinogenemia and raised CRP in generalized neonatal bacterial infections. Serum C3d was evaluated using a counter-immunoelectrophoresis technique following a step of removal of C3 split products. Twelve patients with septicemia, 8 patients with highly probable infection and 134 normal controls were included in the study. The sensitivities for neutropenia, hyperfibrinogenemia, raised CRP and positive C3d were 21, 45, 60 and 70%, respectively, with a significant difference between the sensitivities of neutropenia and positive C3d (p < 0.01). The specificities were found to be 99.2, 99.2, 100 and 97.7% respectively. Thus the C3d qualitative test appears to be as reliable as CRP in the diagnosis of neonatal bacterial infections.
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PMID:Comparative study of four tests of bacterial infection in the neonate. Total neutrophil count, CRP, fibrinogen and C3d. 786 32

Reactive hyperemia after 1 min of arterial occlusion was studied in back, thigh and heel skin of 40 preterm and full-term neonates using laser Doppler flowmetry. Twelve infants had clinical signs of septicemia, but normal laboratory tests at the time of fluxmetry. However, CRP, leukocyte count and the ratio of immature to total neutrophils increased during the following days and septicemia was confirmed by positive blood cultures (septic group). Seven neonates with clinical signs of septicemia had developed neither positive blood cultures nor laboratory signs (non-septic group). Fifteen were healthy neonates. In the septic neonates, time to reach maximal hyperemia, maximum post-occlusive hyperemia and recovery time of skin perfusion were increased significantly in back and thigh skin and the heal skin temperature was decreased when compared to healthy neonates. Healthy and non-septic neonates showed no significant difference in any of the parameters. We conclude that altered reactive hyperemia in the skin may be an earlier sign of neonatal septicemia than laboratory tests.
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PMID:Reactive hyperemia of skin microcirculation in septic neonates. 798 55

A clinical Phase I study of E5, edobacomab, an anti-endotoxin monoclonal IgM antibody was carried out to evaluate its efficacy, safety and pharmacokinetics and in parallel, explore an optimum dosage in the treatment of patients with gram-negative sepsis (incl. those suspected). A total of 10 patients were administered a dose of 1 mg/kg, 2 mg/kg or 4 mg/kg of E5 by infusion over one hour. 1. Peak blood levels after an intravenous dose of 1 mg/kg, 2 mg/kg and 4 mg/kg of E5 were 9.9, 11.5 and 35.6 micrograms/ml, respectively and the half-lives of elimination were 8.7, 11.7 and 10.8 hours, respectively, about the same at all dose levels. The area under the blood concentration-time curve (AUC) were 129.8, 200.8 and 574.4 micrograms.hr/ml, respectively, showing an increase in proportion with the dosage. 2. Urinary E5 concentration was not detectable in all the patients and renal excretion of unchanged E5 was not observed. 3. Out of the 8 patients with a positive pre-treatment endotoxin level with a value of above 9.8 pg/ml, those who showed its reduction to a level of below 9.8 pg/ml within one hour after dosing of E5 were 0 of 2 patients (0%) at a dose of 1 mg/kg, 3 of 3 (100%) at a dose of 2 mg/kg and 1 of 3 (33.3%) at a dose of 4 mg/kg. 4. The clinical efficacy following a single intravenous dose of E5 was rated as being "good" or "excellent" for 3 of 3 patients (100%) at a dose of 1 mg/kg, 4 of 4 (100%) at a dose of 2 mg/kg and 2 of 3 (66.7%) at a dose of 4 mg/kg. 5. As for antipyretic effect as assessed by the mean value of temperature, a fall in fever to the level of 36 degrees C was noted from 12 hours after administration of E5 in the patients treated with 2 mg/kg. The degree of improvement in WBC, platelet count and CRP was also more evident in this 2 mg/kg group. 6. The safety was rated as "no problem in safety" for all 10 patients. No adverse reaction and clinical laboratory abnormalities suspected of their relation to E5 was observed. 7. Positive antibody (HAMA) response to E5 was observed in 2 of the 10 patients. In one patient (4 mg/kg) of them, response because negative 9 weeks later and in the other patient (1 mg/kg) it tended to decrease.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Phase I study of edobacomab (E5) in patients with gram-negative sepsis]. 813 80

The efficacy, safety and usefulness of murine anti-endotoxin monoclonal IgM antibody "E5, an intravenous dose of 2 mg/kg" were evaluated in 88 patients with suspected Gram-negative sepsis from 37 institutes in Japan. Out of these, 74 patients were evaluable for the efficacy, 85 for safety and 75 for clinical usefulness. In assessing the efficacy, the patients were divided into 3 groups based on the plasma endotoxin levels (Endospecy with new PCA treatment of plasma): H group with a level of above 9.8 pg/ml and M group with a level of 3.0-9.8 pg/ml and L group with a level of below 3.0 pg/ml. 1. The efficacy rates as assessed following administration of E5 were 73.1% in the H group, 70.4% in the M group and 38.1% in the L group being higher in the groups with significantly high plasma endotoxin levels. 2. In both the H and M groups in whom plasma endotoxin levels were significantly high, the majority of the patients showed rapid reduction of the levels after administration of E5. 3. In all groups, improvement in body temperature, pulse rate, blood TNF-alpha and blood IL-6 was observed after treatment with E5. In the H and M groups with an endotoxin level of > or = 3.0 pg/ml, improvement in platelet count as well as in CRP was noted. The H group showed also improvement in WBC. 4. Improvement in the shock score was noted in all the groups but was more outstanding in the H and M groups in the early stage of treatment. 5. Side effects were seen in 5 (5.9%) of 85 patients and all thought to be allergic in symptoms such as rash, itching, fever and flare. 6. The reaction to the prick test performed before administration of E5 was negative in all these 5 patients. For 3 of the 5 patients, anti-E5 IgE antibody was measured. In all of them, the IgE levels were higher than those of healthy controls. Also, in 47.6% of patients, an elevation of anti-E5 IgG antibody was noted two weeks after the administration. 7. Clinical laboratory abnormalities were observed in 3 (3.5%) of 85 patients. They were an elevation of S-GOT.S-GPT and lowering of BUN, increased Al-p and decreased CH50, increased neutrophilia (%) and were all slight in the degree of the changes. 8. The clinical usefulness of E5 was evaluated for 75 patients.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Phase II study of edobacomab (E5) in the treatment of gram-negative sepsis]. 813 82

Clinical effects of sulbactam/cefoperazone (SBT/CPZ) was studied on variety of bacterial infections in the fields of internal medicine focused mainly on respiratory infections. The total 135 infections were consisted of 103 respiratory infections, 15 urinary tract infections, 4 sepsis, 7 biliary tract infections, and 6 other infections, of which 86 patients had underlying diseases. The daily doses of SBT/CPZ were 2 to 6 g divided into 2 to 3 times i.v. or d.i.v., and the duration of administration was from 3 to 35 days. The clinical effects were judged by the attending doctors based on the changes in fever, cough, rales, chest rentogenograms, white blood cell counts, CRP values, ESR, etc. The total efficacy rate was 76.9%, and 69.0% of the isolated organism was eradicated by SBT/CPZ. The side effect was noted in 1 case, and the abnormal laboratory findings were noted in 1 case, however it was difficult to determine whether they were due to SBT/CPZ. These results suggest that the clinical usefulness of SBT/CPZ for the infections in the fields of internal medicine.
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PMID:[Multicenter study of the effects of sulbactam/cefoperazone on bacterial infections in the fields of internal medicine focused mainly on respiratory infections in Tochigi Prefecture]. 825 94

Serial estimation of CRP and m-ESR was done in 65 clinically suspected cases of septicemia and 25 healthy controls. Of these 65, 12 (18%) had a negative CRP test at the time of diagnosis and rest all had significantly elevated CRP and m-ESR compared to matched controls at the time of diagnosis. A persistently negative CRP test indicated bad prognosis. With treatment a declining trend of CRP was seen in survivors, but in deteriorating/expired babies the levels kept on increasing. However, m-ESR had no prognostic significance.
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PMID:Diagnostic and prognostic role of CRP and m-ESR in neonatal septicemia. 836 85


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