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

From August 1980 through July 1984, 19 neonates had sepsis due to Haemophilus influenzae. Onset of disease occurred within 48 hours after birth of all the neonates. One neonate was born at term and 18 were born prematurely, including seven neonates born before 28 weeks' gestation. Eight neonates and one fetus died, six of them within 24 hours of birth. Acute chorioamnionitis was present in the placentas. Those neonates with the most severe placental inflammation survived while all of those who died had moderate or only mild chorioamnionitis. Acute villitis was noted in the placentas of three neonates who died. Respiratory distress syndrome (in 15 neonates) and pneumonia (in 15 neonates) were noted in 18 liveborn patients. Nine mothers had fever, six of them with genitourinary infections and one with septicemia due to H influenzae. All isolates of H influenzae were submitted for serologic typing and none were typable. In 14 cases, isolates were biotyped yielding eight with biotype II, four with biotype III, and one each with biotypes IV and V. Neonatal sepsis due to nontypable H influenzae is now nearly as common as sepsis due to group B Streptococcus. Both organisms produce diseases with many features in common, especially fulminant courses with respiratory distress and pneumonia, and often have a fatal outcome.
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PMID:Neonatal sepsis due to nontypable Haemophilus influenzae. 348 94

Plasma endotoxin levels and granulocyte functions (chemiluminescence and chemotaxis) were determined in fifty-two patients with postoperative sepsis. Seventeen had concurrent respiratory distress syndrome (RDS group) and the remaining thirty-five were free of the syndrome (non-RDS group). The plasma endotoxin concentrations were higher in the RDS group than in the non-RDS group (p less than 0.001). All nine patients with particularly high levels (greater than 80 pg) belonged to the RDS group. We noted a positive correlation in chemiluminescence (p less than 0.001, r = 0.67) and a negative correlation in chemotactic activity (p less than 0.001, r = 0.69). To determine whether endotoxin alters normal granulocyte functions in vitro, healthy granulocytes were treated by the endotoxin (E. coli 0111:B4). There was an increase in chemiluminescence and a decrease in chemotactic activity, as observed in vivo. Furthermore, normal granulocytes chemiluminescence was increased by pretreatment of RDS plasma showing high endotoxin levels in vitro (n = 4, p less than 0.05). Thus, endotoxin in the plasma probably plays an important role in marked changes in peripheral granulocyte functions in patients with respiratory distress syndrome.
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PMID:Plasma endotoxin levels and functions of peripheral granulocytes in surgical patients with respiratory distress syndrome. 382 Aug 64

Since bacterial infection in newborns must be treated as specifically and as early as possible, it is important to confirm a diagnosis of suspected infection based on clinical symptoms and to take possible pathogens into consideration when choosing therapy. RDS and septicemia with Group B streptococci can present very similar clinical symptoms, but leucopenia on the first day of life is most probably an indication of septicemia with Group B streptococci. Septicemia caused by other pathogens, however, usually has a much later onset. In the days following birth a raised cardiothoracic index indicates RDS. Other differential criteria are being investigated.
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PMID:[Clinical differentiation between idiopathic respiratory distress, neonatal septicemia caused by group B streptococci and septicemia caused by other pathogens (author's transl)]. 677 86

Respiratory distress syndrome is the clinical manifestation of injury to the terminal alveolar-capillary unit, and may result from a variety of nonpulmonary insults including shock, sepsis, and trauma. The clinical characteristics, pathophysiology, and treatment of respiratory distress syndrome in children are reviewed.
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PMID:Adult respiratory distress syndrome in children. 699 15

This review deals with the various indications, the choice of blood products and the main aspects of their administration for transfusing neonates. Some special problems peculiar to neonatal age, that both neonatologists and blood transfusion services have to take into account, are emphasized. Exchange transfusion in the procedure most frequently used in blood transfusion therapy of neonatal hyperbilirubinaemia of various aetiology, severe anaemia and hyperviscosity due to polycythaemia. The procedure also represents a rational therapeutic approach in the bleeding thrombocytopenic newborn. More recently exchange transfusion has been utilized in the management of DIC, RDS and sepsis. Besides its advantages, metabolic, haemorrhagic and cardiac hazards of this "massive transfusion" are considered. Just as at any other age, the red cell preparation is the blood component most frequently utilized in the transfusion therapy of the neonate, considering not only the treatment of anaemia without hypovolaemic shock, but also the cases of iatrogenic blood loss, a common problem in the high risk neonatal intensive care unit. As transfusion of small increments of blood may often be required for the sick neonate and premature infant, different methods to cope with such conditions are discussed.
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PMID:Blood transfusion therapy in the newborn. 702 55

Eight cases of materno-fetal listeriosis were discovered at the University Women's Hospital of Basel from May 1977 until June 1980. This represent an incidence of 0,15% of all births. This infectious disease has often a fatal course for the unborn child, therefore it is important to know the clinical manifestations occurring with it. Listeriosis during pregnancy has a typical-two-stage course: During the first phase we see commonly a flu-like illness abating rapidly, about two weeks later fever starts again and premature contractions ensue, but no therapy is successful in controlling the fever and the premature labour. The usual fate for the unborn child is stillbirth or premature delivery with subsequent neonatal death due to prematurity, RDS, sepsis and meningitis. The low fetal and neonatal survival rate can be improved by two relatively simple measures: 1) a high index of suspicion with early diagnosis, 2) an early treatment with ampicillin either in the antepartal or neonatal stage. We review the epidemiology, the bacteriology, the serology and the histo-pathology of this relatively rare but important disease during pregnancy.
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PMID:[Listeriosis during pregnancy (author's transl)]. 720 Jun 83

The incidence of RDS varies in various parts of the world and appears to be lower in negroes than caucasian and mongolians. The incidence in mongolians is as high if not higher than in caucasians. The difference between negroes and other races may be due to the ability of the negro fetus to produce surfactant earlier. Variation within the black ethnic groups may be due to genetic differences between them. Studies on the incidence of RDS will be more accurate if surfactant deficiency is documented and other conditions, particularly transient respiratory distress and early neonatal sepsis which both may mimic RDS are recognised.
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PMID:The incidence of the respiratory distress syndrome: with particular reference to developing countries. 721 Jan 65

Between 1974 and 1979, 15 extremely ill neonates with necrotizing enterocolitis (NEC) were initially treated with peritoneal drainage under local anesthesia for intestinal perforation. They weighed 600 to 3040 g with half less than 1000 g. Most had other serious illnesses (RDS, PDA, jaundice, CNS abnormalities). There were no immediate complications such as hemorrhage or bowel evisceration from the local drainage procedures. Seven of the 15 (46%) survived. Three (20%) died because of unrelated problems (CNS, liver failure) with an intact gastrointestinal tract, while another 8 (34%) died from intestinal sepsis. Seven (87%) of the neonates weighing less than 1000 g had an adequately functioning GI tract after this drainage procedure. Half of the neonates requiring additional surgery within 24 hr of initial peritoneal drainage survived and half of the neonates requiring subsequent surgery survived. Five of 15 infants developed strictures one died before excision. This technique is contrary to standard practice and was employed in less than 10% of the neonates with NEC treated at our institution. These results indicate that this method is effective in possibly temporizing the very ill neonate with NEC. An added bonus, however, is that 40% of the neonates treated in this fashion had complete resolution of their disease without residual scarring of the gastrointestinal tract requiring further surgery. It is our continued conclusion that this form of peritoneal drainage under local anesthesia is warranted in certain carefully selected instances.
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PMID:Peritoneal drainage under local anesthesia for necrotizing enterocolitis (NEC) perforation: a second look. 741 69

Respiratory distress syndrome (RDS) is associated with prematurity-related deficiency of surfactant. Surfactant replacement therapy has been used in premature infants to prevent RDS or reduce its severity. In this study we describe the pathology of the lungs after surfactant replacement therapy. All the neonatal autopsies during the years 1989 and 1990 (n = 235) were examined. Infants > or = 31 weeks gestation, with congenital anomalies or who lived more than 2 weeks were excluded from the study. Infants who had received intratracheal Survanta, a modified surfactant extracted from cow lung (n = 14), were compared with infants who did not receive exogenous surfactant (n = 20). The two groups were statistically comparable in terms of weight, gestational and postnatal age, gender, and clinical management. H&E-stained lung sections were examined independently by two pathologists without knowledge of surfactant treatment status; any discrepancies in histological evaluation were resolved by joint review. Nine histological features were evaluated including hyaline membranes, necrosis of the epithelium, hemorrhage, edema, inflammation, metaplasia, arteriolar muscular hyperplasia, interstitial fibrosis, and pulmonary interstitial emphysema (PIE). Histological changes were graded from 0 to 3+. When it was present, cerebral periventricular-intraventricular hemorrhage (PVH-IVH) was graded 1-4. The presence or absence of sepsis and necrotizing enterocolitis (NEC) were also determined. Comparisons between patient groups were performed using the Mann-Whitney U, Student's t and chi 2 tests. The severity of hyaline membrane disease, PIE, and epithelial necrosis was less severe in the surfactant-treated group than in the untreated group. There were no differences between the two groups in the degree of pulmonary hemorrhage or in the incidence of PVH-IVH, sepsis, or NEC.
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PMID:Pathology of the lung in surfactant-treated neonates. 797 82

Because management of premature rupture of the membranes (PROM) at or before 26 weeks is controversial, we examined maternal and perinatal outcome after expectant management of 44 pregnancies complicated by this problem. Mean gestational age at preterm PROM was 23.9 +/- 1.7 (SD) weeks. The latency period between preterm PROM and delivery ranged from 1 to 68 days, with a medium of 6. Of the patients, 54.6% delivered within a week of PROM, and 79.5% delivered by four weeks; 77.2% developed chorioamnionitis, but despite this high incidence, there was no maternal sepsis or pelvic thrombophlebitis, and no maternal surgery was necessary. Perinatal outcome was 60.5% neonatal survival, 54.2% perinatal survival and a stillbirth rate of 10.4%. Respiratory distress syndrome, bronchopulmonary dysplasia, sepsis and intraventricular hemorrhage were common types of neonatal morbidity. There was no pulmonary hypoplasia, and limb deformity was seen in only two neonates. Costs of expectant management in pregnancies complicated by second-trimester PROM were estimated, and a strategy to reduce cost is suggested.
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PMID:Pregnancy outcome after expectant management of premature rupture of the membranes in the second trimester. 812 Aug 52


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