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

A 1 year follow-up study of 289 low birth weight infants (LBW) was carried out during 1984-85 in slums of Bombay: 151 were males and 138 were females. 52.9% of babies had birth weight less than 2.5 kg. Male children suffered 9.7 and females 8.6 episodes of sickness per year. Annual mean episodes of illness were: diarrhea 3.2, cough 5.3, and fever 4.8. Upper respiratory tract infection was considered fever. 98.6% breast fed successfully in the 1st week keeping it up for 2 months. Of 209 mothers, 88.5% had weaned their babies before 6 months. Commercial formula was used by only 1 mother whose baby had gastroenteritis and dies. Of 289 infants, bottle feeding was done in only 3 cases. Feeding with bowl and spoon was done in 71.3% of infants, 27.7% were not weaned at all with breastfeeding lasting 1 year. Most babies lost weight around the 7th and 8th months of life along with maximum episodes of sickness. Babies below 2 kg showed accelerated growth after weaning, and achieved grade I nutritional status. 2.7 to 3 kg weight babies failed to show any gain from the 5th month, thus advanced to 3rd grade malnutrition. 6 deaths occurred, 4 of which had birth weights less than 2 kg. 2 babies died of gastroenteritis and septicemia during the 4th and 5th month. Mortality in babies born less than 2 kg was 44.4% and above 2 kg birth weight was less that 1%. The infant mortality rate (IMR) was 38/1000 live births vs. the national range of 39-177. Prematurity caused 1.2% of deaths. Antenatal care, detection of at risk pregnancies, proper feeding and weaning practices, and complete immunization coverage can help reduce IMR in slums, and the goal of a rate below 60 by the year 2000 is feasible.
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PMID:Care of low birth weight babies in slums. 280 50

An autopsy case of smoldering adult T-cell leukemia (ATL) is presented. 67 year-old woman was admitted to our hospital with complaints of fever, cough and increasing dyspnea on October 2, 1985. Laboratory findings revealed high LDH, azothermia and slightly leukocytosis with low percentage of flower cells. CRP was strongly positive. Gas disturbance was markedly. Anti-ATLA antibody using indirect immunofluorescence method was X40 positive. Subsets of peripheral lymphocytes showed OKT 4 dominant. (OKT 3; 67.5%, OKT4; 60.6%, OKT8; 8.8%). A chest X-ray film revealed cardiomegaly and fine granular shadows in bilateral lower pulmonary fields. Diagnosis of interstitial pneumonitis was defined in transbronchial lung biopsy (TBLB) specimen. O2 therapy, steroid therapy added antibiotics were ineffective, respiratory failure and renal failure were progressive, she died by septic shock in 39th hospital days. In autopsy, no characteristic histological changes of ATL were found in lymph node, bone marrow, spleen, liver, kidney and lung. Sepsis was the cause was of death. Finally this case diagnosed smoldering ATL and pulmonary fibrosis due to bronchial ectasia with repeated pulmonary bacterial infections. The pulmonary complications of patients with ATL were discussed.
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PMID:[Smoldering adult T-cell leukemia complicating severe respiratory failure--an autopsy case report]. 288 12

Published reports have indicated that patients with Kartagener's syndrome (dextrocardia, sinusitis and bronchiectasis) have no significant lung mucociliary clearance. With a radioaerosol technique we measured over a 6-hour observation period the tracheobronchial clearance of 8 patients with dextrocardia, chronic bronchial sepsis and chronic sinusitis (DC). The tracheobronchial clearance of these patients was significantly reduced (p less than 0.02) compared with that of 29 healthy subjects of similar age. However, even when allowance was made for productive coughing during the observation period, the reduced clearance was much better than anticipated from published reports in patients with Kartagener's syndrome, which confined their observations to a 2-hour period. The tracheobronchial clearance of the DC patients, adjusted for productive coughing, was as bad as that found in an older group of patients with chronic obstructive airways disease who refrained from expectorating during the equivalent test period. Our study implies one or more of the following possibilities: (a) a spectrum of mucociliary impairment in patients with DC; (b) an effective cough clearance deeper in the lung than hitherto believed, and (c) two-phase flow of mucus cephalad as an effective clearance mechanism in patients with DC.
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PMID:Impaired mucus clearance in patients with chronic bronchial sepsis, sinusitis and dextrocardia. 342 Mar 7

Eight cases of pulmonary involvement were observed in 17 severe cases of ictero-haemorrhagic leptospirosis. Haemoptysis (7 cases) occurred on the 4th day of the infectious syndrome and was associated with other haemorrhagic manifestations in 4 cases. Cough, pain and polypnoea were not constant. Chest X-ray showed diffuse, non-specific changes, such as nodular opacities or infiltrates. Septicaemia was confirmed in all cases with acute renal failure in 7 cases and meningitis in 6 cases. Severe thrombocytopenia was demonstrated in 2 cases. Six patients recovered quickly with regression of the lung changes within 12 days. Two patients died, one of a fulminant haemoptysis related to a disseminated intravascular coagulation syndrome, and the other of acute respiratory failure. All cases were confirmed serologically. Although lung changes in leptospirosis are usually benign and mild, haemoptysis and polypnoea with diffuse radiological changes are poor prognostic factors. The pathological changes were similar to those of haemorrhagic alveolitis. These changes may be either due to the liberation of toxins or to an immunological phenomenon.
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PMID:[Pulmonary manifestations in severe ictero-hemorrhagic leptospirosis]. 363 26

Pharmacokinetics and clinical effects of ceftizoxime (CZX), a new cephalosporin antibiotic, were investigated and following results were obtained. 1) Ceftizoxime was given by intravenous injection or drip infusion for 1 hour at a single dose of 30 mg/kg. After intravenous injection, the mean peak serum level of 3 children was 95.9 mcg/ml at 15 minutes and half-life time was 1.18 hours. After 1 hour drip infusion, the mean peak serum level of 3 children was 79.5 mcg/ml at the end of infusion and half-life time was 1.20 hours. The urinary level was high and the mean urinary recovery rate was 69.6% and 63.4% up to 6 hours after intravenous injection and 1 hour drip infusion, respectively. 2) CZX was administered in dose of 39--76 mg/kg to 7 pediatric patients (4 cases of purulent meningitis, 2 of septicemia with purulent meningitis, and 1 of aseptic meningitis) by a single intravenous injection. In patients with purulent meningitis, passage into the cerebrospinal fluid was relatively as good as 30% of serum level at the same time in the presence of remarkable signs of inflammation, but poor in cases of mild inflammation or aseptic meningitis. 3) Cerebral puncture fluid level in 1 patient with cerebral abscess was as good as 65.5% of serum level at the same time. 4) CZX was given to 28 cases of respiratory tract infection, 1 of tonsillitis with otitis media, 6 of scarlet fever, 1 each of maxillary sinusitis and bacterial endocarditis, 6 of purulent meningitis, 2 of septicemia, 5 of septicemia suspected, 2 of septicemia with purulent meningitis, 1 each of osteomyelitis, typhoid fever, peritonitis and biliary tract infection, 16 of urinary tract infection, 14 of skin and soft tissue infection, and 1 of external otitis, totaling 87 cases. The mean daily dose of 101.6 mg/kg was administered for an average of 10 days mainly by intravenous injection 4 times daily. Clinical results obtained were excellent in 34 cases, and good in 46. Bacteriological effectiveness rate was 100%. As for side effects, fever, fever with rash, fever with cough and diarrhea appeared in 1 each case out of 182 cases including 95 drop out cases. As for laboratory findings, eosinophilia, thrombocytopenia, elevation of GOT, that of GOT with GPT, and that of GOT with LDH appeared in 10, 2, 2, 3 and 1 cases, respectively.
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PMID:[Pharmacokinetics and clinical effects of ceftizoxime in pediatric field (author's transl)]. 627 4

The amount of oxygen in mixed venous blood (SvO2) is a reliable indicator of the status of oxygenation of tissue in most clinical settings. Monitoring levels of SvO2 might, therefore, aid in managing critically ill patients. A recently developed adult pulmonary arterial catheter provides continuous measurement of SvO2 via fiberoptic bundles incorporated into the catheter, in addition to measuring hemodynamic pressures and cardiac output by thermodilution. We evaluated 100 consecutive fiberoptic catheters for accuracy and reliability of the system in 86 critically ill adult patients and determined the clinical usefulness that knowledge of SvO2 provided. Over a range of hemoglobin saturations from 24 to 85 percent, the correlation coefficient between in vivo SvO2 vs photometrically measured samples for 199 paired measurements was 0.95. Mean duration of usage for 33 catheters in the medical intensive care unit was 6.1 days; all catheters functioned normally until clinical conditions permitted removal. Continuous measurements of SvO2 detected unsuspected increases in tissue oxygen consumption during coughing spasms and positioning of the patient. In nine of 13 patients with hypoxemic respiratory failure requiring positive end-expiratory pressure (PEEP), we found a strong correlation (r = 0.88) between oxygen delivery and SvO2. Of the four patients not showing correlation, two had sepsis, and two had nearly normal values of SvO2 and oxygen delivery at all levels of PEEP studied. Continuous measurement of SvO2 improves monitoring of patients, facilitates titration of respiratory therapies, detects abrupt changes in tissue oxygen consumption, and identifies levels of PEEP associated with greatest oxygen delivery.
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PMID:Clinical experience with continuous monitoring of mixed venous oxygen saturation in respiratory failure. 648 14

Mycoplasma mycoides subspecies mycoides (large-colony type) was isolated from the lungs of a goat with pneumonia. Clinical signs included inappetence, weakness, listlessness, coughing, dyspnea, pyrexia, slight nasal discharge, and lameness. Tylosin (4 mg/kg of body weight) was administered each day for 4 days, resulting in slow recovery. Three weeks later, the clinical signs recurred and the kid was anemic. It was given a single blood transfusion and tylosin was administered daily. The kid's health status was steadily declined and it died after 6 days' treatment. At necropsy, the lungs were edematous and congested. Histopathologic findings were those of septicemia and pneumonia.
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PMID:Pneumonia in goats caused by Mycoplasma mycoides subspecies mycoides. 700 31

Out of 130 children under 12 years of age with a diagnosis of typhoid fever, nine were under two years of age; the youngest was five months old. Six patients were males and the most frequent findings were: high fever, poor physical condition, vomiting, diarrhea, malnutrition, dehydration, meteorism, liver and spleen enlargement, cough, bleeding disorders and central nervous system abnormalities which were suggestive of sepsis. The clinical diagnosis was confirmed in all patients through the isolation of Salmonella typhi in blood cultures. The Widal reaction showed higher than 1/160 "O" and "H" agglutinin titers in five out of six patients in which it was performed. Neutrophilia was observed in all cases, with a shift to the left in five of them. Anemia was present in all of them. The following complications were found: hepatitis (1 case), hepatitis and meningitis (1 case), bronchopneumonia (1 case), and bleeding abnormalities (4 cases). Two of the patients died; the deaths were attributed to late diagnosis and insufficient antibiotic treatment.
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PMID:[Typhoid fever in children under 2 years of age]. 727 78

Your recent lead article on toxic shock and tampons (November 1, p. 1161) prompts me to report a case of pelvic infection and staphylococcal septicemia 8 days after the insertion of a Lippes loop. Pelvic infection is a recognized complication of IUDs; although there have been 2 reports of endocarditis occurring in susceptible patients following the insertion of an IUD, septicemia is rare. A previously healthy 31-year old married woman had a loop inserted at a family planning clinic. 3 days later she developed sweating, vomiting, confusion, and cough and during the following 48 hours became disoriented with hallucinations. She was referred to the hospital with suspected encephalitis and on admission was febrile (38.8 degrees Celsius) and stuporose but responded to simple commands. Blood pressure was 95/60 mmHg but there were no other abnormal signs. Hemoglobin was 12.2 g/dl, white blood count 4.0x109/1 (80% neutrophils), erythrocyte sedimentation rate 70mm in the 1st hour; cerebrospinal fluid normal. Chest x-ray examination revealed patchy consolidation in the upper lobes of both lungs and an electroencephalogram showed bilateral nonspecific abnormality. 3 blood cultures taken on admission yielded penicillin-resistant Staphylococcus aureus. She was treated with high-dose intravenous cloxacillin and 24 hours after starting the antibiotic had improved markedly and the IUD was removed. Culture from the coil and also from a high vaginal swab yielded Staph aureus with a similar antibiogram to that of the organism cultured from the blood. Subsequent recovery was uneventful, although repeat chest x-ray examination showed small abscess cavities in the upper lobes of both lungs. The patient was discharged 4 weeks after admission and serial chest radiographs have confirmed complete resolution of the pneumonia and abscesses. There is little doubt that this patients' septicemia with lung abscess formation and encephalopathy originated in the genital tract. The patient was both toxic and shocked but was different from patients with the recently described toxic shock syndrome in that her blood culture was positive for Staph aureus. The case provides another example of the importance of this organism as a cause of infection associated with the insertion of foreign bodies into or through the vagina.
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PMID:Staphylococcal septicaemia after insertion of an intrauterine contraceptive device. 744 49

To determine whether inexperienced health workers can recognize severe infection in infants less than 3 months of age, a study was conducted of 200 infants with cough, fever or 'not feeling well'. The presence or absence of five symptoms: cough, difficulty in breathing, feeding problem, fever or history of convulsions, and ten signs: appearing ill, respiratory rate > or = 60/min, chest indrawing, grunting, cyanosis, wheeze, lethargy, 'too hot', 'too cold' or abdominal distension, were recorded by a health worker, who made a diagnosis of 'ill' or 'mildly ill'. Each infant was then reviewed by an experienced paediatrician who made a diagnosis of 'ill' (pneumonia, sepsis, meningitis or other severe illness) or 'mildly ill'. Using these diagnoses as the 'gold standard', the sensitivity, specificity, and positive predictive values of each parameter were calculated. In 89% of the 200 infants, the health worker made the correct diagnosis. Forty infants were admitted. In 36 instances (90%) the health worker made the correct decision. The most discriminating symptoms and signs were 'not feeding well', 'appears ill', chest indrawing and grunting. A respiratory rate > or = 60/min was 78% sensitive and 69% specific. Our study suggests that inexperienced health workers can recognize severe illness in infants under 3 months of age.
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PMID:Recognition of illness in very young infants by inexperienced health workers. 750 92


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