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

Serum lactoferrin concentrations were elevated in almost all children with meningococcal septicemia, in whom the disease had been clinically apparent for less than 18 hours, while the concentrations were normal or only moderately elevated in patients who had had the disease longer before being admitted. Concentrations of C-reactive protein (CRP) were markedly elevated, even with a time lapse of less than six hours, making this the most suitable parameter for the early diagnosis of severe meningococcal infection. Following an operative injury on children the lactoferrin concentrations changed very little. More than six hours after an operation, however, a marked increase in CRP-values was observed, possibly indicating differentiation of this response from that of bacterial infection. The concomitant study of serum alpha 1-antitrypsin, alpha 1-antichymotrypsin, orosomucoid and haptoglobin did not uncover results of great significance with regard to early changes.
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PMID:The latency of serum acute phase proteins in meningococcal septicemia, with special emphasis on lactoferrin. 660 36

A group of 52 patients with premature rupture of the membranes (PROM) before 34 weeks' gestation were evaluated prospectively and managed expectantly. Of 42 patients who were delivered of their infants, 26 (61.9%) had significant chorioamnionitis on histopathology, and 18 had positive microbial cultures at delivery. However, only seven patients (16.7%) developed clinical signs of chorioamnionitis. There were no maternal deaths or perinatal deaths attributable to sepsis. Only two infants (less than 5%) had positive blood cultures. All patients were assessed daily for the development of chorioamnionitis. Amniocenteses were not routinely performed. White blood cell counts, band neutrophil counts, and erythrocyte sedimentation rate determinations were found to be unreliable. C-reactive protein determinations were found most reliable with a high sensitivity and specificity. Elevated C-reactive protein levels correlated better with pathologic confirmation of chorioamnionitis than with the clinical febrile morbidity. Clinical implications for the management of PROM are discussed.
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PMID:Premature rupture of membranes: the role of C-reactive protein in the prediction of chorioamnionitis. 662 89

C-reactive protein (CRP) concentrations were monitored serially in 97 patients with abdominal sepsis to determine if differences in infection type or site would produce diagnostic or prognostic CRP level elevations. After surgery and abdominal infection, the average (+/- SD) CRP peak values were 21.2 +/- 9.0 mg/dL. The CRP values rose markedly with infection, rose further with surgery, and subsided to less than 10 mg/dL with cure. Persistent levels of more than 10 mg/dL indicated abscess formation or continued infection. The average normal value at complete tissue healing after resolution of infection was 1.2 mg/dL, which was not different from that for healthy volunteers. Analysis suggested that CRP concentrations were not predictive of the type, site, or severity of abdominal infection; however, since persistent elevations were frequently associated with new or unresolved bacterial infection, serial determinations may be helpful in monitoring the course of disease and response to treatment.
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PMID:C-reactive protein as an indicator of infection relapse in patients with abdominal sepsis. 669 24

A total of 813 patients from the years 1976 to 1980 who had a bacteremic Haemophilus influenzae infection were analyzed. Special attention was paid to disease entities (16.5% of the total) other than meningitis (60.5%) or epiglottitis (23.0%). Ninety-six cases in the nonmeningitis, nonepiglottitis (NMNE) group showed the following distribution: 25 patients with septicemia without specific focus, 21 arthritis, 19 cellulitis, 17 pneumonia, six otitis, four local abscess, two laryngotracheobronchitis, and two with an eye infection. Eighty-eight percent of the cases were children who were less than 5 years old; in the septicemia and pneumonia groups, however, 33 percent were 15 years of age and older, and 10 percent were over 60 years of age. All diseases in the NMNE group were acute; 51 percent of the patients sought medical advice within two days. C-reactive protein (CRP) was elevated constantly at presentation, erythrocyte sedimentation rate (ESR) was increased (greater than 20 mm/hr) in 87 percent, high fever greater than 38.5 degrees C (101.3 degrees F) was measured in 85 percent, and leukocytosis (greater than 15 X 10(9)/l) was present in 71 percent. Various antimicrobial agents were given for an average of 17 days. The mean period of hospitalization was 13 days. Case fatality rate was 4 percent; all deaths occurred among patients with an underlying disease. No permanent damage was observed.
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PMID:Systemic Haemophilus influenzae infection in Finland. 670 35

This prospective study evaluated host resistance in a surgical population who walked into the hospital for elective surgery. Patients were stratified into Hospital Reactive (HR, n = 19) if they reacted to two or more of five recall skin test antigens and Walk-in Anergic (WA, n = 26) if they did not react to the antigens. The WA patients were slightly older (74.4 +/- 1.8 years, +/- SEM versus 66.7 +/- 2.7 p less than 0.05). Diagnosis in the HR and WA group were: tumors 13/19 versus 21/26, diverticulitis 3/19 versus 0/19, and miscellaneous 3/19 versus 5/26. Twenty-five laboratory normal controls (LN) were also studied. There were no significant differences in the following parameters between the HR and WA groups: stage of disease; hemoglobin; circulating leukocyte count; polymorphonuclear cell counts; total lymphocyte counts (both groups lower than LN, p less than 0.05), monocyte counts (both higher than LN, p less than 0.05); per cent E-rosettes and lymphocyte blastogenesis to mitogens (phytohemagglutinin, concanavalin-A) and antigens (purified protein derivative and tetanus); phagocytosis of preopsonised Staphylococcus aureus 502A, at 5, 10, and 20 minutes; alpha, beta, and gamma globulins; C3, and total hemolytic complement (CH50) levels; C-reactive protein; and ANA and DNA levels. The HR group demonstrated an increase in the rate of killing of Staphylococcus 502A at 10, 20, 40, and 80 minutes compared to the LN group but the WA group did not show this augmentation (p less than 0.001). The serum albumins were: LN = 4.46, HR = 3.98, WA = 3.43 g/dl (p less than 0.05). Degree and duration of surgery was the same in the HR and WA groups. There were no major sepsis episodes (bacteremia or proven intracavitary abscess) in the HR patients versus 25% in the WA patients (p less than 0.05). There was one death (6%, pulmonary embolus) in the HR group and 8 (40%) in the WA group (p less than 0.05). Antibiotic prophylaxis was equal but the WA patients received therapeutic antibiotics more frequently (65% versus 11% p less than 0.05). Of all the host immunocompetence tests measured in this study, the delayed type hypersensitivity skin test response and the serum albumin were variables abnormal between the survivors and those who died.
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PMID:The walk-in anergic patient. How best to assess the risk of sepsis following elective surgery. 671 20

Serum levels of C-reactive protein (CRP) were measured within 96 hours of birth in 55 neonates with respiratory distress syndrome (RDS), 19 neonates with no significant medical illness other than an unstable cardiovascular state, and 13 neonates with a variety of pulmonary and extra-pulmonary problems either alone or in combination with RDS. The median serum CRP level in patients with RDS (2 micrograms/ml) was neither elevated nor different from CRP levels in infants with unstable cardiovascular systems (median CRP level, 2 micrograms/ml); however, neonates with other problems including pneumonia, aspiration, and extrapulmonary sepsis had significantly elevated serum CRP values (median 24 micrograms/ml). CRP levels are not elevated in neonatal RDS. Measurement of this acute phase reactant provides a rapid and reliable means of helping to distinguish infants with uncomplicated RDS from those with other serious pulmonary and extrapulmonary disease.
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PMID:Serum levels of C-reactive protein in neonatal respiratory distress syndrome. 672 84

C-reactive protein (CRP) was determined serially in 31 patients with premature rupture of the membranes, 41 patients in premature labor, and 18 pregnant patients with a variety of high-risk conditions. Elevated levels of CRP were not predictive of clinical amnionitis, histologic chorioamnionitis, or neonatal sepsis. No discernible relationship was found between serum CRP and peripheral white blood cell count. CRP was not elevated (false negative) in two patients in the premature labor group with culture-proved bacterial amnionitis. Elevated CRP in the absence of infection (false positive) likewise occurred. The results suggest that CRP be used in conjunction with other signs and symptoms suggestive of chorioamnionitis, rather than as a pathognomonic test.
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PMID:C-reactive protein with premature rupture of membranes and premature labor. 685 22

In order to evaluate the usefulness of some laboratory studies in the diagnosis of neonatal sepsis, a prospective study was done in 56 patients: Group I (n = 19) with a single infectious site, group II (n = 16) with two infectious sites and group III (n = 21) with two infectious sites and positive blood culture. All of them had platelet count, erythrosedimentation rate (ESR), alpha-1-antitrypsin, orosomucoid, and C-reactive protein made; according to the results we gave an arbitrary low score when it was between 0 and 2 high when it reached 3 to 6 points. During the acute phase of the illness, 86% of the infants of group III, 69% of group II and 5% of group I had a high score. Even though the diagnostic possibilities were increased with the use of alpha-1-antitrypsin, orosomucoid and C-reactive protein, we think that these laboratory studies are not more useful than platelet count and ESR in the diagnosis of neonatal sepsis.
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PMID:[Evaluation of various laboratory tests for the diagnosis of septicemia in the newborn infant]. 697 May 81

Five tests have been used in combination to diagnose neonatal sepsis. This study describes their use in 56 infants evaluated between 8 and 60 days of age, who had nonspecific signs of infection at presentation, as well as further evidence in 524 infants evaluated in the first week after birth. When two or more of the five tests had abnormal results (leukocyte count less than 5,000/ cu mm; immature/total neutrophils greater than or equal to 0.2; ESR greater than or equal to 15 mm/hr; latex C-reactive protein, positive; and latex haptoglobin, positive), a "sepsis screen" was considered positive. A positive screen was found in 23 infants, ten of whom had proved sepsis, and only two had no evidence of infection. With the addition of a leukocyte count greater than 20,000/cu mm, the remaining two cases of sepsis would have been detected. In those with a negative screen (n = 33), 26 had no evidence of infection. The sepsis screen seems to be a useful adjunct in the diagnosis of neonatal sepsis during and beyond the first week.
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PMID:Detection of neonatal sepsis of late onset. 705 52

Authors develop a comparative study of two acute phase reactants behaviour, in the follow up on 27 neonates with confirmed sepsis of favourable evolution and in 15 cases with fatal evolution. Results show that sera levels C-reactive-protein follow a parallel course with clinical significance in patients reaching normal concentrations soon after favourable evolution and persisting in high level or even increasing previous ones, in cases of lethal evolution. Orosomucoid did show the same clinical-biological correlation maintaining generally in high levels independent of normalization of symptoms and C-reactive protein. They propose serial determination of C-reactive-protein and an efficient control of treatment in neonatal sepsis.
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PMID:[C-reactive protein and orosomucoid as parameters of developmental monitoring and therapeutic effectiveness in neonatal sepsis]. 715 63


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