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

Nosocomial sinusitis is occasionally overlooked as a source of sepsis in critically ill patients. Physical examination is usually unreliable and purulent nasal discharge is absent up to 73% of the time. Computed tomography scans of the sinuses and aspiration and culture of sinus fluid are the hallmark of diagnosis. Therapy consists of removal of tubes and packing, appropriate antibiotics, and drainage. Risk factors for nosocomial sinusitis include nasotracheal tubes, nasogastric tubes, prior steroid and antibiotic therapy, and facial fractures. This article reports a case of suppurative sinusitis following prolonged intubation and reviews the literature.
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PMID:Suppurative sinusitis in critically ill patients: a case report and review of the literature. 129

Sinusitis secondary to nasotracheal intubation has not been reported to occur in neurosurgical patients. Over a 1-year period, 11 patients admitted to the Intensive Care/Trauma Unit at St. Paul Ramsey Medical Center developed this entity. The mean age of these patients was 36 +/- 4 years; 7 were trauma victims, 3 had each had a subarachnoid hemorrhage, and 1 had suffered hypertensive hemorrhage. The patients presented with fever of unknown origin (FUO) and evidence of persistent hypermetabolism without an obvious cause. In 8 cases, the diagnosis was not suspected until mucopurulent nasal discharge was noted. Three additional cases were evaluated for suspected sinusitis before the occurrence of discharge. The mean duration of intubation before the diagnosis of sinusitis was 7.8 +/- 1.5 days. The diagnosis was confirmed by sinus films with a Waters view in 7 cases or by computed tomographic scanning in 4 cases and by bacteriological cultures. Two cases involved only the maxillary sinus on the side of intubation; the rest were polysinusites. The organisms involved included gram-positive and gram-negative species; all were polymicrobial with a single organism predominant. Secondary pulmonary involvement was common, and 4 patients revealed a bacteremia consistent with the major sinus organism. One patient developed septic shock. Treatment involved either orotracheal intubation or tracheostomy. This was curative in all cases. It is concluded that neurosurgical patients nasally intubated are at risk for sinusitis, which can have untoward effects such as septicemia or pulmonary infection. A high degree of suspicion will permit early diagnosis and treatment.
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PMID:Paranasal sinusitis: a common complication of nasotracheal intubation in neurosurgical patients. 403 81

A 14-year-old, 76-kg female orangutan (Pongo pygmaeus) aborted a premature fetus and within hours experienced severe respiratory distress and died. Necropsy revealed evidence of chronic airsacculitis, acute bronchopneumonia, and terminal sepsis. Escherichia coli was isolated from cultures of heart blood, tracheal fluid, air-sac tissue and fluid, lung, and bile. Retrospectively, it was established that the animal had had a periodic nasal discharge for many months. The aborted infant had no evidence of infection.
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PMID:Fatal airsacculitis and pneumonia, with abortion, in an orangutan. 700 4

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

A 3-month-old boy was admitted with failure to thrive and persistent fevers. During a 4 month hospitalization for treatment of suspected sepsis, persistent purulent nasal discharge developed. Biopsies of his nasal mucosa on 3 separate occasions disclosed thinned respiratory epithelium and a complete absence of cilia when examined by electron microscopy (EM). Despite an initial granulocytopenia and a wide range in T-cell numbers, he did not show any evidence of lower respiratory tract infection. A tracheal biopsy process for EM demonstrated normal ciliated epithelium. This patient appears to have an unrecognized syndrome of normal tracheal cilia but absent nasal cilia.
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PMID:Scanning and transmission electron microscopic aspects of the nasal acilia syndrome. 707 Jan 71

Infections occurred in 52 of 400 patients (13%) undergoing coronary artery bypass operations from January 1987 to December 1990. The hospital courses of 5 patients (1.3%) in whom occult infections of the paranasal sinuses developed were reviewed. Only 1 patient had specific clinical findings of acute sinusitis (purulent nasal discharge). Computed tomography showed wall thickening, opacification, or air-fluid levels in one or more paranasal sinuses in each patient. All patients were successfully treated with surgical drainage and antibiotics. Risk factors for development of postoperative acute sinusitis include: prolonged tracheal intubation, airway colonization with nosocomial bacteria, inability to clear nasal secretions, sinus ostial obstruction, and critical organ system dysfunction. Physical examination and roentgenographic evaluation of the paranasal sinuses should be considered when postoperative sepsis of obscure etiology occurs.
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PMID:Paranasal sinusitis: cryptic sepsis after coronary artery bypass operations. 845 34

Four outbreaks of hemorrhagic septicemia caused by Pasteurella multocida multocida occurred in a population of 1,800 fallow deer (Dama dama) during 1992-1996. A total of 340 fallow deer were submitted for postmortem examination. Pasteurellosis was diagnosed in 273 of 312 deer suspected of having septicemia. Pasteurella multocida was isolated from 257 animals, and the diagnosis was based on typical pathologic changes alone in the other 16 animals. Pasteurella multocida was isolated in pure culture from 219 of 248 samples of cerebrospinal fluid. Eighteen animals were observed moribund with severe depression, foamy nasal discharge, and respiratory distress, and 257 were found dead. Major clinical signs and pathologic changes included extensive swelling of the head and the neck and peracute or acute septic pneumonia, petechial and ecchymotic hemorrhages on serous membranes, and severely hemorrhagic adrenal glands and abomasum. Rhinitis and necrotic pharyngeal mucosae were common. Histologically, the most advanced lesions were in the nasal mucosa and pharynx. The swelling of the head and the neck arose from a diffuse cellulitis in the subcutaneous and intermuscular tissues. The earliest lesions in the lungs included large numbers of bacteria in the pulmonary capillaries, but various degrees of fibrinous exudation to the alveoli and infiltration with heterophils usually were observed.
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PMID:Hemorrhagic septicemia in fallow deer (Dama dama) caused by Pasteurella multocida multocida. 1048 48

We report here a case of Pasteurella multocida infection caused by cat exposure presenting with septic shock, sinusitis, and pneumonia. The patient was a febrile 20-year-old woman who had been experiencing disturbed consciousness progressively. She had close contact with a domestic cat and had received some scratches on both arms. A magnetic resonance imaging (MRI) scan of the head showed a high intensity in the paranasal cavity, and a computed tomographic (CT) scan of the chest showed bilateral lung consolidations. The pathogen was identified as P. multocida by the cultures from blood and nasal discharge. She was given intensive antibiotic therapy with ceftriaxone and piperacillin, continuous hemodiafiltration (CHDF) therapy, and anticoagulation therapy. Owing to these therapeutic regimens, the septic shock was successfully treated without complications. We also review the literature on P. multocida septicemia.
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PMID:Pasteurella multocida septicemia caused by close contact with a domestic cat: case report and literature review. 1536 69

67 prolongely intubated patients from intensive care unit were under our observation. Were performed ultrasound examination and CT scan of paranasal sinuses in prolongely intubated patients. In the same patients it was performed the examination of tympanic cavity by acoustic impendansometry. Also was performed bacteriologic examination of nasal discharge in prolongely intubated patients. Our investigations showed, that in prolongely intubated patients there is a high risk of development of polysinusitis and evstachitis, which can lead to so called fever of unknown origin and even to chronic sepsis. According to the authors, sanitation of nasal cavity must be performed every day at least 1 time, and if there is the shade--at least 2 times every day. To create the negative pressure, it is rational to use iamic--catheter and, through which activation of mucocilliary transport is performed. Changing of nasogastral probe is rational after one day by turns in each nasal pass. It is rational to cleanse places of pressing of these probes with the antiseptic solutions.
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PMID:[Dynamics of paranasal sinus and tympanic membrane changes in prolongely intubated patients]. 1657 29

Two captive cottontop tamarins (Sanguinus oedipus) died within 5 d of each other from systemic infection by Francisella tularensis (tularemia). One tamarin experienced mild clinical signs, including malaise, anorexia, and a mucoid nasal discharge for 4 d before death, whereas the other experienced a more rapid progression of disease that lasted less than 24 h. Differential diagnoses included gram-negative septicemia by an organism such as Escherichia coli, Salmonella, or Yersinia; protozoal infection such as Toxoplasma gondii or an acute viral infection such as lymphocytic choriomeningitis. F. tularensis infection was identified by F. tularensis-specific PCR in both primates. Possible sources of infection include aerosol, biting arthropod vectors, and transmission via a rodent reservoir. This case report highlights the importance of tularemia as a differential diagnosis in acute febrile illness in captive nonhuman primates.
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PMID:Septic tularemia in 2 cottontop tamarins(Sanguinus oedipus). 2277 56


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