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

Two infants with clinical and radiologic features of metatropic dwarfism presented in the neonatal period with episodes of cyanosis. Diagnostic studies to determine the etiology of these spells, including electrocardiogram, electroencephalogram, arterial blood gases, and metabolic and sepsis studies, were unremarkable. Chest roentgenograms revealed the characteristic long, narrow thoracic cage with no evidence of parenchymal disease. Cervical spine stability evaluation, pulmonary function studies, and chest impedance monitoring with qualitative air flow thermistor studies and transcutaneous oxygen monitoring were carried out. Both patients demonstrated a significant increase in resistance of the respiratory system following passive maneuvering of the head from a neutral position, suggestive of hypopharyngeal air flow obstruction. Obstructive sleep apnea resulting in cyanosis was documented in both patients. All other studies failed to yield a cause for the episodes of cyanosis. Our investigation failed to alter the clinical course which resulted in respiratory arrest and death by 7 months of age. A table is presented for the differentiation of skeletal dysplasias presenting in the perinatal period.
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PMID:Respiratory complications of metatropic dwarfism. 401 1

A neonate with total anomalous pulmonary venous connection draining via the right cardinal vein into the superior vena cava had a chest-X-ray unsuspicious for congenital heart disease, and initially was treated for neonatal sepsis. But as the clinical state impaired and cyanosis increased, sectorechocardiography revealed the right diagnosis. The child died soon after corrective surgery.
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PMID:[Unremarkable heart and mediastinal configuration in a newborn infant with totally anomalous pulmonary venous anastomosis to the superior vena cava]. 405 33

Bacterial infections are frequent events in premature and newborn infants. The reason is a defective specific and nonspecific defence of bacterial organisms. Some immunoglobulins like IgM and IgA including secretory IgA are absent. Premature infants also show a decreased level of IgG. Cellular immunity is anatomically intact but functionally defective. A number of complement factors are lacking, the activation of the alternative pathway is impaired. Newborn infants with perinatal problems like asphyxia or difficult delivery, show defects of leucocyte function like decreased deformability, defective chemotaxis and defective killing of ingested bacteria. Certain diseases, like hypoxia and malformations of immature organ functions in this age group (decreased acid production in the stomach), facilitate bacterial colonization of surface epithelia and the invasion of tissues. Consequences of these pathogenetic mechanisms are an unimpaired propagation of bacterial organisms into the blood and meninges without localization of the infecting organisms at the entry site. Bacterial meningitis is not considered a separate disease entity but a complication of bacteremia and sepsis. Clinical symptoms are nonspecific at the onset of the infection. Fever is frequently absent; decreased appetite, vomiting, a bloated abdomen, diarrhea, tachycardia, tachypnea are early signs of a bacterial infection, a grey mottled appearance, cyanosis, jaundice, petechiae, apneic spells, seizure activity and a metabolic acidosis are symptoms of advanced infection. Successful treatment at this stage is often not possible. Every sign of a decreased well being of a newborn of premature infant warrants laboratory and bacteriologic work up for septicemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Chemotherapy of severe bacterial infections in pediatrics]. 631 69

Two patients developed acute oliguric renal failure following paraphenylene-diamine intoxication. The associated clinical features included vomiting, angioneurotic edema, cyanosis, intravascular hemolysis and methemoglobinemia. Therapeutic dialysis and symptomatic management was followed by complete recovery in one, and death due to septicemia during the oliguric phase in the other patient. Renal histology in both cases revealed acute tubular necrosis. The pathogenetic mechanisms involved in the development of acute renal failure following paraphenylene-diamine have been discussed.
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PMID:Acute renal failure following paraphenylene diamine [hair dye] poisoning: report of two cases. 695 50

The neonatal and obstetric approaches to preventing group B streptococcal neonatal infections are reviewed. Although recent reports recommend prophylactic antibiotic treatment of antepartum and intrapartum group B streptococcal carriers and low-birth-weight infants, acceptance of these schemes is not widespread. A preliminary study to evaluate the value of semiquantitative vaginal and cervical cultures of antepartum women for group B streptococcus in predicting maternal and neonatal infectious morbidity revealed: 1) 11% of the study population were carriers (group B streptococcus isolated from broth only) but only 2.8% had heavy colonization (growth in broth and on streaked plates), and 2) morbidity associated with 8 heavily colonized mothers during the current pregnancy included group B streptococcal endometritis (1 patient), neonatal sepsis (1), and readmission of a newborn for transient cyanosis (1). Two of the heavily colonized mothers were known carriers in their last pregnancy; 1 had group B streptococcal endometritis and the infant of the second developed clinical sepsis at 2 weeks of age. The clinical value of semiquantitative culture techniques requires additional investigation.
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PMID:Group B streptococcal neonatal infection: clinical review of plans for prevention and preliminary report of quantitative antepartum cultures. 699 Mar 32

Knowledge of the changes during transition from fetal to neonatal circulation is useful for the understanding of physiologic and pathologic variations in the neonatal cardiovascular system. Cyanosis as well as clinical symptoms of congestive heart failure in the neonate are unspecific and may represent cardiac and noncardiac disease (primary pulmonary disease, septicemia, intracranial haemorrhage or meningitis, polyglobulism). Besides detailed analysis of clinical symptoms, the examination of arterial bloodgases when breathing from room air and 100% oxygen, the electrocardiogram, the chest-roentgenogram, and the echocardiogram are of diagnostic value. Specific cardiovascular problems during the neonatal period are the patent ductus arteriosus in the premature infant and the so-called persistent fetal circulation. Among the many congenital cardiac defects potentially causing problems in the neonate the most important are complete transposition of the great arteries, coarctation of the aorta, hypoplastic left heart syndrome, and severe tetralogy of Fallot or pulmonary atresia with ventricular septal defect. With good cooperation between obstetrician, neonatologist and paediatric cardiologist, most neonates with cardiologic problems can nowadays be timely diagnosed and successfully treated.
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PMID:[Cardiological problems in the neonatal period (author's transl)]. 719 20

A newborn baby is admitted in the second week of life with osteomyelitis and septicemia due to Staph. aureus infection. In his tenth week of life--the osteomyelitis nearly overcome--the infant shows signs of heart failure with a murmur and cyanosis. Cardiac catheterization reveals tricuspid insufficiency and thrombosis of the right pulmonary artery. Postmortem examination shows isolated polypous endocarditis of the tricuspid valve together with thrombosis of the right and recent embolus of the left pulmonary artery. A similar case has to the best of our knowledge not been described.
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PMID:[Isolated endocarditis of the tricuspid valve in early infancy]. 720 2

A case of salicylate hepatitis in a seven-week-old boy with Kawasaki's disease, mucocutaneous lymph node syndrome, is reported. The infant was admitted to the hospital with fever and a diffuse maculopapular petechial rash. He was treated with antibiotics for 72 hours for presumed septicemia. His condition deteriorated and he developed mucous membrane lesions and edema in his hands and feet. When the cultures of spinal fluid, blood, and urine were found to be negative, the antimicrobial therapy was discontinued; however, the cyanosis of his extremities progressed and gangrenous regions developed in his toe and finger pads. Oral aspirin therapy was started at a dosage of 100 mg/kg/day, every six hours. After five days, the rash, membrane lesions, and swelling in his hands and feet resolved. The cyanosis regressed. Liver enzyme tests revealed mild elevations of SGOT and LDH, and on the 12th hospital day these values peaked to a level consistent with salicylate hepatitis. The aspirin therapy was discontinued and within four days the liver function test results were normal. Aspirin therapy was reinstituted at a single daily dose of 30 mg/kg with no recurrence of hepatitis. The careful monitoring of liver function tests is recommended for children with Kawasaki's disease receiving aspirin therapy to avoid salicylate-induced hepatitis.
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PMID:Salicylate hepatitis: a complication of the treatment of Kawasaki's disease. 727 May 63

A study based on clinical analysis was conducted regarding the 125 episodes in the elderly 112 patients of sepsis who were 70 (average 83.8 +/- 7.5) years old at Nagoyashi-Koseiin Geriatric Hospital from 1985 through 1994. 1) The backgrounds of the elderly patients with sepsis were as follows: bedridden (72.8%), urinary catheter in place (61.2%), central venous catheter in place (48.8%), and prior antibiotic use (40.8%). All patients had an underlying disease. 2) Organisms isolated were Escherichia coli (21.2%), Staphylococcus aureus (18.4%); Coagulase-negative staphylococci (CNS) (17.4%) and Candida albicans (6.1%). Chronologically, the quantity of gram-positive cocci increased while that of gram-negative bacilli decreased. As the age of the patients increased, the frequency of infections by Methicillin-resistant Staphylococcus aureus (MRSA), E. coli, and/or multiple bacteria increased, while that of infections by CNS and gram-negative bacilli excluding E. coli decreased. 3) The primary infected sites were the urinary tract system (24.8%), central venous catheter (21.6%) and unknown (31.2%). 4) The primary clinical observations were fever exceeding 38.0 degrees C (88.0%), tachycardia (60.8%), shivering (44.0%) and cyanosis (32.8%). 5) Complications were multiple organ failure (33.6%), septic shock (26.4%) and disseminated intravascular coagulation (22.4%). 6) The prognosis indicated that 65.6% were survivors, and 34.4% were nonsurvivors. At the onset of sepsis, weight, blood pressure, serum albumin, and total cholesterol in the nonsurvivors were significantly lower than those in the survivors, whereas heart rate, GOT, LDH, and BUN in the nonsurvivors were significantly higher than those in the survivors.
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PMID:[Study on sepsis in the elderly at Nagoyashi-Koseiin Geriatric Hospital]. 749 17

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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