Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ticlopidine is a powerful antiplatelet activator that inhibits adenosine diphosphate (ADP)-induced platelet aggregation. Its most common side-effects are skin rashes, diarrhea and neutropenia. Aplastic anemia is rare. This paper reports a patient with severe aplastic anemia that developed after the use of ticlopidine. The 85-year-old woman developed fever, chills and chest pain 5 weeks after starting ticlopidine 250 mg twice daily. Severe aplastic anemia was proved by blood examination, bone marrow aspiration and biopsy. In spite of the recovery of absolute neutrophil count to more than 1,000/mm3, 16 days after ticlopidine was stopped and administration of strong antibiotics, the patient died from candidal sepsis.
 ...
PMID:Severe aplastic anemia induced by ticlopidine: report of a case. 852 78

Pyrogenic reactions are characterized by fever, chills, hypotension, or a combination of these developing during or shortly after hemodialysis in a previously asymptomatic patient. The temporal association with treatment implicates exposure of the patient's blood to bacterial pyrogens from contaminated dialysate or a reused dialyzer. Routine body temperature monitoring is recommended to detect these exposures. The current study was prompted by the appearance of several symptomatic febrile episodes in patients who were asymptomatic and afebrile before treatment with high-flux hemodialysis. During a 6 month period, temperatures were measured with a digital oral thermometer before and after 9,605 high-flux hemodialyses in 163 patients. Elevations above 100 degrees F (37.8 degrees C) were observed during or after 33 dialyses in 15 patients. In 18 of these dialyses, the temperature was also elevated before treatment began. Four patients who had no symptoms or fever before dialysis accounted for febrile reactions during 11 of the remaining 15 dialysis treatments. Fever was accompanied by rigors during most of the episodes. Subsequent blood cultures grew Enterococcus faecalis (two), Enterobacter cloacae (two), and Pseudomonas aeruginosa and cepacia (one). All four patients had indwelling silastic double lumen venous catheters (PermCaths), all responded to intravenous antibiotics, and all required eventual removal of the catheter. The apparent precipitation of sepsis by dialysis indicates that shear forces caused by high pulsatile blood flow through the catheter may dislodge organisms that have colonized the lumen. Intraluminal instillation of antibiotics is suggested as a preventative measure.
 ...
PMID:Catheter related bacterial infections mimic reactions to exogenous pyrogens during hemodialysis. 855 99

A 47-year-old man presented with a history of fever, chills and weight loss for 3 months. He had been treated for diabetes mellitus during the past 3 years. He developed high fever with abnormal liver function tests. Both Widal and Weil-Felix reactions were negative with normal roentgenogram of the chest. His anti-HIV tests were positive. The cultures from the blood and sputum yielded pure Sphingobacterium multivorum sensitive to sulfamethoxazole-trimethoprim, chloramphenicol, tetracycline, cefotaxime, ceftazidine and ceftriaxone. On the next day, the patient developed signs and symptoms of meningitis with the CSF containing chronic and acute inflammatory cells but revealed no growth on culture. The patient was treated with a combination of ceftriazone and trimethoprim-sulfamethoxazole but he died on the 6th day after admission. This patient was the fifth reported case infected with S.multivorum. It illustrates that this potentially pathogenic organism can cause septicemia in an immunodeficient patient.
 ...
PMID:Sphingobacterium multivorum septicemia: a case report. 885 15

Patients who use PermCath as the vascular access for long-term hemodialysis are occasionally confronted with catheter-related infections. Recently, we have treated 17 patients suffering from PermCath-related sepsis. The clinical presenting features were leukocytosis in 14/17, high fever and shaking chill during dialysis in 12/17, and signs of exit site infection in 3/17. No shock was found. All patients received clinical evaluation to exclude infection sources other than from blood and inside the catheter, such as pulmonary, genitourinary, hepatobiliary and cutaneous systems. Blood drawn from both PermCath and peripheral vein was sent for bacterial culture. Bacterial culture of the blood samples from PermCath revealed Staphylococcus sp. in 7/17, Pseudomonas sp. in 5/17, Enterobacter sp. in 4/17, Streptococcus sp. in 1/17. Fourteen blood samples from peripheral vein showed positive culture results identical to those from PermCath, but negative study were noted in three other patients. The patients were divided into two treatment groups: Group I: systemic antibiotics without PermCath removal in 7, Group II: "locked-in" retention in addition to systemic anti-biotics in 10. Antibiotics were empirically chosen according to bacteriological studies. In the "locked-in" retention treatment, antibiotics were retained into both the inflow and outflow PermCath lumens in the exact volume of each lumen for 24 hours. The antibiotics solutions were replaced on a daily basis. The same antibiotics were also given intravenously. Duration of treatment depended on clinical progression and follow-up blood culture results and ranged between 13 and 24 days. The schedule of dialysis was not changed through the period of PermCath-related sepsis. The sepsis was cured in all group II cases but not in 2 of group I and resulted in mortality in these 2 patients. The PermCaths were preserved in 5/7 in group I with two mortality cases and all except one preserved in group II patients without mortality. We suggested that "locked-in" retention in addition to systemic antibiotics is the treatment of choice for the patients with PermCath-related sepsis. This method also preserves the functional integrity of PermCath, which is the lifeline vascular access of the patients with exhausted native vessels.
 ...
PMID:Treatment of PermCath-related sepsis in uremic patients. 910 2

The purpose of this prospective study was to evaluate the safety of salvage and reinfusion of postoperative sanguineous wound drainage using the ConstaVac Blood Conservation System (Stryker, Kalamazoo, MI). A prospective analysis of 135 primary total hip and total knee arthroplasties was carried out. The collection time for reinfusion was limited to 6 hours, and suction pressure was kept to a minimum by using the lowest setting on the device. For all patients, no citrate-phosphate-dextrose anticoagulant was added to the reservoir. To evaluate the effect of reinfusion on hemostasis and the blood coagulation system, antithrombin III, fibrinogen, and D-dimer levels of 40 of 135 patients were measured before surgery and on the first and seventh days after the operation. The mean volume of reinfusion of postoperative drainage was 437 mL for the patients with total hip arthroplasties, 883 mL for those with total knee arthroplasties, and 1,713 mL for those with bilateral total knee arthroplasties. Ninety-nine of 135 patients underwent operations without homologous blood replacement. Transient chills with mild fever were seen in 2 patients during reinfusion. No complications related to air embolism, coagulopathy, renal failure, or sepsis were recognized in any of the patients. This study suggests that postoperative blood salvage and reinfusion appear to be safe and effective in patients undergoing primary total hip and knee arthroplasties.
 ...
PMID:Postoperative blood salvage and reinfusion after total joint arthroplasty. 926 90

Vibrio vulnificus is a marine Gram-negative bacillus that is recognized as a cause of fulminant primary septicemia and wound infections. One of the most common bacteria in seawater, V. vulnificus is concentrated in ocean filter feeders (e.g., oysters and clams). Primary septicemia can occur in patients, typically with underlying liver disease, who have acquired the organism through the gastrointestinal tract after recent consumption of raw shellfish. Characterized by fevers, chills, and bullous skin lesions, V. vulnificus septicemia is associated with a mortality greater than 50%. With septic shock, mortality approaches 100%. Wound infections are seen after injury to the skin in a marine environment or from exposure of preexisting wounds to seawater. Because of the high morbidity and mortality associated with V. vulnificus infections, effective treatment includes preventive measures to educate high-risk individuals, early search for and recognition of the disease, aggressive antibiotic therapy, supportive care, and, in the case of wound infections, aggressive debridement. Review of this subject was prompted by a case of V. vulnificus primary septicemia and fulminant septic shock in a patient with the unusual presentation of pain in the lower extremities.
 ...
PMID:Clinical infections of Vibrio vulnificus: a case report and review of the literature. 947 62

Immunotherapy consisting in intravesical injection of BCG vaccine to a 44-year-old patient with surface relapsing cancer of the bladder resulted in development of sepsis. The vaccine in a dose of 120 mg was injected directly after bougienage of the urethra and catheterization of the bladder. As soon as in 2 h the patient developed chill, fever (38.5 degrees C), and felt bad. The condition progressed, but only in 15 days did the patient applied for medical care. Intensive care including antibiotics and antituberculous drugs in massive doses and repeated sessions of hemoperfusion were of no avail. The patient died with signs of progressive hepatorenal failure. Autopsy confirmed vaccinal mycobacterial sepsis. Intravesical immunotherapy after injury to the urethra was an error, promoting generalization of the infection; another cause of lethal outcome was late application for medical care.
 ...
PMID:[A rare case of BCG vaccinal sepsis in a patient with bladder cancer]. 951 Dec 49

A Phase I dose escalation trial of i.v. administered recombinant human interleukin 12 (rhIL-12) was performed to determine its toxicity, maximum tolerated dose (MTD), pharmacokinetics, and biological and potential antineoplastic effects. Cohorts of four to six patients with advanced cancer, Karnofsky performance >/=70%, and normal organ function received escalating doses (3-1000 ng/kg/day) of rhIL-12 (Genetics Institute, Inc.) by bolus i.v. injection once as an inpatient and then, after a 2-week rest period, once daily for five days every 3 weeks as an outpatient. Therapy was withheld for grade 3 toxicity (grade 4 hyperbilirubinemia or neutropenia), and dose escalation was halted if three of six patients experienced a dose-limiting toxicity (DLT). After establishment of the MTD, eight more patients were enrolled to further assess the safety, pharmacokinetics, and immunobiology of this dose. Forty patients were enrolled, including 20 with renal cancer, 12 with melanoma, and 5 with colon cancer; 25 patients had received prior systemic therapy. Common toxicities included fever/chills, fatigue, nausea, vomiting, and headache. Fever was first observed at the 3 ng/kg dose level, typically occurred 8-12 h after rhIL-12 administration, and was incompletely suppressed with nonsteroidal anti-inflammatory drugs. Routine laboratory changes included anemia, neutropenia, lymphopenia, hyperglycemia, thrombocytopenia, and hypoalbuminemia. DLTs included oral stomatitis and liver function test abnormalities, predominantly elevated transaminases, which occurred in three of four patients at the 1000 ng/kg dose level. The 500 ng/kg dose level was determined to be the MTD. This dose, administered by this schedule, was associated with asymptomatic hepatic function test abnormalities in three patients and an onstudy death due to Clostridia perfringens septicemia but was otherwise well tolerated by the 14 patients treated in the dose escalation and safety phases. The T1/2 elimination of rhIL-12 was calculated to be 5.3-9.6 h. Biological effects included dose-dependent increases in circulating IFN-gamma, which exhibited attenuation with subsequent cycles. Serum neopterin rose in a reproducible fashion regardless of dose or cycle. Tumor necrosis factor alpha was not detected by ELISA. One of 40 patients developed a low titer antibody to rhIL-12. Lymphopenia was observed at all dose levels, with recovery occurring within several days of completing treatment without rebound lymphocytosis. There was one partial response (renal cell cancer) and one transient complete response (melanoma), both in previously untreated patients. Four additional patients received all proposed treatment without disease progression. rhIL-12 administered according to this schedule is biologically and clinically active at doses tolerable by most patients in an outpatient setting. Nonetheless, additional Phase I studies examining different schedules and the mechanisms of the specific DLTs are indicated before proceeding to Phase II testing.
 ...
PMID:Phase I evaluation of intravenous recombinant human interleukin 12 in patients with advanced malignancies. 981 99

A 35 year old female was admitted into the hospital because of rapid onset fever and chills. Streptococcus pneumoniae could be isolated from blood as the responsible pathogen for septicemia. Necroses of fingers and feet occurred. The clinical signs of an overwhelming post-splenectomy infection (OPSI) were evident. High-dose penicillin was administered and the patient recovered. Howell-Jolly-bodies were seen in peripheral blood smears. A spleen within normal size could be demonstrated in CT and sonography. Angiologic findings showed intact splenic arteries and a normal vein, whereas the small splenic vessels were rare. MRT of the spleen using Endorem (Fe), showed only a minimal uptake of the RES. In a scintigram of spleen and liver using 320 MBq Tc-99m nanokoll, the spleen was not visible. Thus, functional asplenia was demonstrated by Howell-Jolly-Bodies and by image methods. An increased antinuclear antibody level and a Sm-antibody lead to the diagnosis of undifferentiated connective tissue disease. As far as we know this is the first case that functional asplenia was the first symptom of a systemic autoimmune disease.
 ...
PMID:[Pneumococcal septicemia in functional asplenia: first manifestation of systemic autoimmune disease?]. 1019 87

Patients with end-stage renal disease commonly develop secondary hyperparathyroidism. Calcitriol may be administered to such patients to decrease the synthesis and secretion of parathyroid hormone (PTH) and to help maintain calcium and phosphorus homeostasis. However, the doses of calcitriol required to suppress serum PTH concentrations can lead to hypercalcemia or hyperphosphatemia in many patients undergoing hemodialysis. Paricalcitol is a new vitamin D analogue that is safe and effective in suppressing elevated concentrations of PTH in patients with established hyperparathyroidism who are maintained on chronic hemodialysis. As with vitamin D, the biologic action of paricalcitol is mediated through activation of the vitamin D receptor (VDR). The VDR functions as a ligand-induced transcription factor regulating the rate of expression of genes that are involved in controlling not only calcium homeostasis and bone remodeling but also hormone secretion, inhibition of cell growth, and induction of cell differentiation. In vitro studies have shown that paricalcitol inhibits PTH secretion from bovine parathyroid cells in a dose-dependent manner. Studies in renally insufficient rats demonstrated that paricalcitol caused approximately 10 times less elevation of serum calcium concentrations than calcitriol. In clinical studies, paricalcitol effectively decreased PTH by about 60% over a 12-week period. Mean serum concentrations of calcium were significantly increased but remained within the normal range. There were occasional (5/414 determinations) transient elevations in serum calcium above the upper limit of normal in some (5/401) patients. Serum phosphorus values did not change significantly compared with baseline, although they tended to be slightly higher in the paricalcitol-treated group than in the group receiving placebo. Elevations of the calcium-times-phosphorus product were relatively few but occurred more often in the paricalcitol than in the placebo group. The terminal half-life of paricalcitol was 5 to 7 hours in healthy subjects; in patients undergoing hemodialysis, it was 14 hours. Adverse events associated with paricalcitol use included, among others, chills, feeling unwell, fever, sepsis, palpitations, dry mouth, gastrointestinal bleeding, nausea, vomiting, edema, light-headedness, and pneumonia. Paricalcitol should be considered as an alternative to calcitriol in the treatment of patients who are undergoing maintenance hemodialysis for end-stage renal disease, as it has a decreased potential to induce hypercalcemia and hyperphosphatemia. Additional studies are required to determine the long-term effects of therapy.
 ...
PMID:Paricalcitol, a new agent for the management of secondary hyperparathyroidism in patients undergoing chronic renal dialysis. 1032 13


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>