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)

The case of a two-month -old female infant, who after a severe diarrhoea treated with prolonged intravenous infusion in peripheral veins alternated with total parenteral feeding, developed a Candida albicans septicemia (accompanied by disseminated intravascular coagulation syndrome) is reported. The course of her disease was also complicated by multiple foci of osteoarthritis in both knees, in the left hip and in several long-bones. Radiographically the foci of Candida osteitis appeared as fine erosion of the cortex and minute round areas of osteolysis in the spongiosa, surrounded by a rim of perifocal sclerosis. During the acute stage of Candida sepsis a transitory cellular immunodeficiency was present. Treatment of Candida infection by 5-fluorocytosine was followed by complete recovery.
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PMID:Disseminated arthritis and osteitis by Candida albicans in a two month old infant receiving parenteral nutrition. 40 39

Three groups of extensive burn patients of the surgical intensive care unit (ICU) have been compared: Group I: twenty patients, who were treated locally without silver sulfadiazinate (1968-1970); Group II: the twenty first patients topically treated with silver sulfadiazinate (1970-1972); Group III: twenty similarly treated patients, with silver sulfadiazinate, six years later (1976-1977). The groups are statistically comparable. All bacteriological samples were computerized; the chi-square method was used for statistical analysis of the data. The main conclusions are: (A) Silver sulfadiazinate treatment reduced Pseudomonas aeruginosa and Proteus sepsis. No change in Coliform bacilli sepsis was observed. After six years, a rise in Klebsiella sepsis and Candida sepsis was noted. (B) A quantitative estimate of infections in each group was made by measuring the percentage of positive samples, taking into account the five above-mentioned strains. In the beginning, silver sulfadiazinate reduced quantitative sepsis, but this benefit decreased after six years; the same evolution was demonstrated for positive blood bacteriology; severe septicaemia showed a parallel pattern.
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PMID:A ten-year retrospective study of sepsis in severely burned patients treated with or without silver sulfadiazinate. 45 85

Candida sepsis has become one of the most common and dangerous forms of hospital acquired infection. The recommended drug for parenteral treatment of Candida sepsis is amphotericin B, however, its toxic effects preclude its usage in many patients, particularly in the presence of renal failure. A less toxic antifungal agent is 5-fluorocytosine. A patient with Candida albicans sepsis was treated successfully with 5-fluorocytosine by intravenous administration. The fungal infection developed during the course of acute renal failure, repeated surgical intervention, intravenous hyperalimentation, gastrointestinal bleeding and five months of antibiotic therapy. The clinical symptoms receded rapidly and cultures became sterile after one week of intravenous treatment. The predisposing factors, difficulties in prevention and diagnosis of fungal infection are discussed.
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PMID:Candida sepsis successfully treated by parenteral administration of 5-fluorocytosine. 96 77

Most infections on the surgical ward are due to one or more gram-negative rods, acting either as the sole pathogens or as principal components in a polymicrobial flora. To date, parenteral aminoglycosides have proven to be the most effective antibiotics for control or treatment of such sepsis. Unfortunately, however, serious complications as well as therapeutic failures do occur. During a 40-month period, 405 surgical patients receiving aminoglycosides (Gentamicin, Tobramycin, Sisomicin, or Amikacin) were prospectively studied with respect to: indications for antibiotic; patient population; serum concentrations of antibiotic according to route of administration, dose in mg/kg/day, and renal function; rapidity of antibiotic excretion in the urine; causative bacteria and their sensitivities to each aminoglycoside as determined by both disc and tube dilution methods; severity and frequency of drug complications; and clinical efficacy of each study antibiotic. Results supported the contention of a superior effectiveness from aminoglycosides for established abdominal and unspecified surgical infections, more rapid development of therapeutic blood levels by intravenous administration, need to alter drug dose according to frequent serum creatinine determinations, increased drug toxicity in dehydrated and shocked patients, preventability of complicating Candida sepsis, and the importance of early as well as adequate surgical debridement and drainage.
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PMID:Use of aminoglycosides in surgical infections. 97 53

Candida sepsis is a very serious complication in severely burned patients. This mainly affects patients whose immune system is weakened by illness and/or by drugs. Often diagnosis is difficult because candida sepsis occurs after an initial infection, but therapy is always difficult. Good fungicidal drugs are available, but their side effects limit their effectivity. Two severely burned patients who were suffering from a gram-negative sepsis confirmed by clinical and laboratory data developed candida sepsis. Conventional therapy failed, and both patients suffered from renal failure with constantly high candida-latex-antigen titre. By means of the liposomal encapsulated amphotericin B, which has the same fungicidal effect as amphotericin B, but without its limiting side effects, both, patients could be saved. The kidneys functioned as normal again, the laboratory findings were normal when the patients were discharged.
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PMID:[Candida infection in the severely burned patient--a successful treatment concept with liposomal amphotericin B]. 128 49

A case of a severe Candida sepsis is reported, which was treated successfully by a combination therapy of flucytosine with fluconazole. After an extensive abdominal operation, a 70-year-old man developed a syndrome of fulminant sepsis due to Candida albicans with the beginnings of renal failure. The latter fact forced us to search for a therapeutic alternative to the classical amphotericin B plus flucytosine combination therapy.
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PMID:Successful treatment of a Candida albicans sepsis with a combination of flucytosine and fluconazole. 130 6

Thirty patients with relapsed pediatric solid tumors received high-dose carboplatin and etoposide with autologous marrow support in a dose-escalation trial. These patients had received extensive prior treatment, which included both cisplatin and etoposide in 25 cases. Six patient cohorts received carboplatin in doses of 1200-2100 mg/m2 and etoposide in doses of 960-1500 mg/m2. All courses were associated with severe neutropenia and thrombocytopenia. The median times from bone marrow infusion to granulocyte recovery (> 0.5 x 10(9)/l) and platelet recovery (> 50 x 10(9)/l) were 33 and 28 days, respectively, with similar findings for all dosage levels. The frequency of non-hematologic toxicities was generally low, although hyponatremia (Na+ < 129 mEq/l) was seen in one-third of the courses. Hepatoxicity was dose-limiting and was significantly associated with the cumulative prior cisplatin dose (p = 0.006). There were four toxic deaths (CNS hemorrhage, alfa-streptococcal sepsis, Candida sepsis, and enterocolitis). Eleven patients received a second course of therapy; toxicity profiles and times to hematologic recovery were similar for the two courses. Clinical responses were observed at all dosage levels. Eleven of 26 evaluable patients achieved a clinical response (one complete, 10 partial). The majority of responses were in patients with neuroblastoma (six of 16) or Hodgkin's disease (two of three). For phase II clinical trials, we recommend dosages of 2100 mg/m2 of carboplatin and 1500 mg/m2 of etoposide for children with prior cumulative cisplatin exposure < 960 mg/m2. This carboplatin dose represents a three- to four-fold increase over pediatric doses tolerated without bone marrow support.
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PMID:Escalating sequential high-dose carboplatin and etoposide with autologous marrow support in children with relapsed solid tumors. 146 10

Both surgical trauma and infection can disturb the proteinase to proteinase inhibitor balance in the circulation. We sought to assess the effect of Candida albicans infection (INFX) on postoperative mortality, to correlate mortality with total serum proteolytic activity (PA), and to assess the impact of exogenous proteinase inhibitors (PI) on this mortality. Mice underwent midline laparotomy (LAP) and immediate postoperative intravenous C. albicans infection. LAP + INFX shortened mean survival compared to INFX or LAP alone. Quantitative renal cultures confirmed that death in the LAP + INFX and INFX groups was due to Candida sepsis. PA was measured using an 125I-labeled protein assay, yielding micrograms of acid-soluble peptides/100 microliters of serum. In control, sham-operated, and LAP groups, PA averaged less than 9.0, and mortality was 0. In INFX and LAP + INFX groups, PA averaged greater than 14.5 and mortality was high. To determine if high PA was related to high mortality, LAP + INFX mice were treated immediately preoperatively with a single dose of PI (1 mg alpha 1-proteinase inhibitor, 1 mg antithrombin, and 1000 KIU aprotinin). Mean survival increased with PI treatment. In conclusion, the addition of Candida infection to surgical trauma hastened mean time to death. More rapid death correlated with elevated PA and may reflect systemic imbalance in the proteinase to proteinase inhibitor ratio in the circulation. PI improved survival, suggesting that proteinase inhibition may prove useful in the future in the treatment of fungal sepsis in surgical patients.
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PMID:Surgical trauma, Candida infection, and serum proteolytic activity. 152 52

From January 1986 through December 1988, we have seen 7 cases of isolated intestinal perforation in 250 infants with birth weights less than 1,000 g (3% incidence) without histological or clinical evidence of necrotizing enterocolitis (NEC). Patients had a mean birth weight of 670 g, gestational age of 25.1 weeks, and sustained a perforation at a chronological age of 10.4 days. No infants had been fed. A definite, blue-discolored abdomen was the only consistent clinical sign (n = 7). Free intraperitoneal air on radiograms was rarely observed (n = 1). Abdominal ultrasounds (n = 3) and metrizamide contrast studies (n = 3) were not diagnostic. The presence of an umbilical artery catheter (7/7), falling hematocrit (6/7), thrombocytopenia (5/7), and a positive diagnostic paracentesis were most commonly found. In 6 of 7 patients, this perforation was associated with coagulase-negative staphylococcal sepsis. Surgical or histological diagnosis showed focal perforation in either the terminal ileum (n = 4) or the transverse and descending colon (n = 3). Survival was 3 of 7; 2 patients died of intracranial hemorrhage and 2 died of Candida sepsis. We conclude that (1) intestinal perforation can occur in the absence of NEC; (2) bluish discoloration of the abdomen is the most reliable clinical finding; and (3) perforation may be associated with coagulase-negative staphylococcal infection.
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PMID:Spontaneous, isolated intestinal perforations in neonates with birth weight less than 1,000 g not associated with necrotizing enterocolitis. 194 64

Pilot in vitro studies demonstrated that nystatin combined with Silvadene (silver sulfadiazine 1% [Marion Laboratories, Inc., Kansas City Mo.]) or Furacin in a 1:1 ratio was equally effective against Candida albicans and ATCC strains of Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli, but Sulfamylon (Winthrop Pharmaceuticals, Winthrop, N.Y.) combined with nystatin demonstrated an antagonistic response. Therefore we examined the susceptibility to nystatin of 165 clinical isolates, both gram-positive and gram-negative, to nystatin combined with Silvadene or Sulfamylon and 144 isolates to nystatin and Furacin. Both Silvadene and Furacin combined with nystatin were equally effective against the microorganisms as were the individual drugs. Conversely, Sulfamylon combined with nystatin lost its antimicrobial capability (93.3% resistance, p less than 0.001). On the basis of the in vitro results, 93 patients with acute burns were treated with the appropriate topical antimicrobials from April 1988 to September 1988. Of the 93 patients treated, 90 had neither a major systemic bacterial nor a Candida sepsis, and none of these patients had associated localized burn wound sepsis during their hospital stays. These 90 patients were discharged without any documented signs of infection. The average burnsize was greater than or equal to 29.44% total body surface area. These data suggest that the antimicrobial properties of nystatin, when combined with Silvadene and Furacin, remain effective. Consequently, such combinations have been effective in controlling both local and systemic Candida and bacterial burn wound sepsis.
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PMID:The efficacy of nystatin combined with topical microbial agents in the treatment of burn wound sepsis. 260 98


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