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

A full-term infant became ill at 16--24 h of age following an uncomplicated pregnancy, labor, and delivery. The clinical course (absence of prenatal warning, rapidly progressive respiratory distress, apnea, shock, and coagulopathy) terminated fatally and resembled that seen in neonatal 'early onset' group B streptococcal sepsis. Previous cases of neonatal group G streptococcal disease are briefly reviewed.
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PMID:Fatal group G streptococcal sepsis in a neonate. 41 76

The purpose of this study was to assess the usefulness of the white cell ratio of immature neutrophils (PMNs) to total (immature plus mature) PMNs as an indication of infection in the very small premature infant. We retrospectively reviewed the charts of 59 premature infants less than or equal to 1,250 g admitted to our Newborn Intensive Care Unit over a one-year period who had at least one white count determined. Twenty-three were born after rupture of membranes for greater than or equal to 24 hours (PROM), 47 had a one-minute Apgar score less than or equal to 6 and 31 had a five-minute Apgar scores less than or equal to 6, 38 had respiratory distress syndrome (RDS), and 4 had confirmed infection. Thirty-one of the infants had a ratio greater than or equal to .15 in the first day of life, a value which has been suggested in the literature as being abnormal and an indication to suspect sepsis. This ratio bore no statistical relationship to PROM, low Apgar scores, or RDS. We analyzed these same relationships using a ratio greater than or equal to .25, another ratio derived from data in the literature which has been said to suggest infection. No statistical correlation was found for low Apgars or RDS, but there was a significant relationship between PROM and attainment of a ratio greater than or equal to .25 (p less than .005). It is notable that 2 out of the 4 infants with infection had a ratio less than .15. We wish to cast doubt on the applicability of the currently defined WBC ratios in the literature as they apply to the infant with birth weight less than 1,250 g and emphasize the apparent effect of PROM as a factor upon these ratios.
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PMID:The white cell ratio in the very low birth weight infant. 45 79

Respiratory distress is the most frequent symptom initiating referral to neonatal intensive care centers. Previous reports have indicated that 40% of infants with sepsis proved by blood culture had respiratory symptoms as their clinical presentation. In this prospective study there were 145 consecutive infants referred because of respiratory distress. Two-site blood cultures were collated with all other clinical and laboratory data to confirm a diagnosis of septicemia. There was a 4.8% incidence of bacteremia, and clinical and laboratory parameters confirmed septicemia in 3.5% of infants studied. Sixty percent of these infants had group B streptococcal sepsis, and 80% had leukopenia. The low incidence of confirmed septicemia in infants referred because of respiratory distress suggests that antibiotic therapy should not be routine.
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PMID:Incidence of sepsis in neonates with clinical respiratory distress. 48 82

Serial TSH and T4 determinations were performed in sixty neonates admitted to our hospital for neonatal intensive care within a period of three months. Seven patients (12%) showed transient hypothyroidism on the basis of low T4 and high TSH values. Only one of these patients, who had meconium aspiration and pneumonia, did not have the respiratory distress syndrome. In addition, 4 of these patients had sepsis. All of the patients were born before 37 gestational weeks and had birth weights under 2200 g. In addition, two patients of this gestational age and birth weight group had a progressive fall of T4 to extremely hypothyroid values without simultaneous elevation of TSH. Two of the 5 patients who died had histological studies of their thyroids. These revealed colloid-depleted vesicles, desquamated epithelium, and prominent vascularisation of the thyroid. The results of this study show that early recognition and therapy of transient hypothyroidism may be live saving.
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PMID:Transient hypothyroidism associated with prematurity, sepsis, and respiratory distress. 49 63

Pulmonary alterations after shock and sepsis, described clinically as shock lung or adult respiratory distress syndrome, are of great importance in intensive care. Pathogenetically an alteration of the surfactant system of the lung is often discussed. Since phospholipids are constituents of lung surfactants, phospholipid metabolism is investigated in experimental peritonitis in rats in our laboratory. 15 hours after inducing a peritonitis, the lung incorporates more oleic acid than that in animals of the reference group. 33 hours after inducing peritonitis, the capacity of the lung to incorporate choline and fatty acids is markedly reduced, histologically the lungs represent morphological equivalents of the so-called shock lung at this time. Therefore we conclude, that an alteration of phospholipid metabolism with a diminished and/or altered synthesis of lung surfactant plays, at least in part, an important role in the pathogenesis of respiratory distress in sepsis and peritonitis.
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PMID:Altered metabolism of phospholipids in the lung of rats with peritonitis. 58 Aug 12

To analyze the risk of cannula sepsis from indwelling umbilical arterial catheters and the indication for prophylactic antibiotics, 137 catheterized neonates with respiratory distress were prospectively placed into either antibiotic-treated (penicillin 50,000U/kg/day and kanamycin 15 mg./kg./day) or non-treated groups. Although bacteria were frequently isolated from blood and catheter tip cultures obtained upon removal of the catheter, especially among non-antibiotic treated infants, these isolates were predominantly non-pathogens and probably skin flora. Corresponding peripheral blood cultures were usually sterile. No cases of cannula-associated sepsis occurred among treated and non-treated newborns. The risk of bacteriologically proven sepsis resulting from an indwelling umbilical artery catheter appears insufficient to justify prophylactic antibiotics.
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PMID:Prophylactic antibiotics in neonates with umbilical artery catheter placement: a prospective study of 137 patients. 60 56

Seven cases of heart arrest or pronounced bradycardia during 308 correct catheterizations of the umbilical vein in the first hours of life are reported. The indications for the catheterization were: 1. unsuccessful catheterization of the umbilical arteries in newborns with respiratory distress or post-asphyxia syndrome; 2. exchange transfusions for severe neonatal hyperbilirubinemia or sepsis; 3. monitoring the central vein pressure in severely compromised shocky newborns. Cardiac massage was always effective, at least temporarily, in restoring the heart activity. However, only three infants survived. Two of them had normal follow-up reported at 6 and 12 months respectively. The immediate risks and the necessary precautions for carrying out umbilical vein catheterization in severely ill newborns in the first hours of life are stressed.
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PMID:Umbilical vessel catheterization; the immediate risks with the venous route. 62 82

An increased morbidity by Streptococcus agalactiae (group B streptococci) during the perinatal period was to be found in some countries since 1961. Six cases of group B streptococcal meningitis were confirmed by the Central Streptococcus Laboratory of the GDR from July to December 1975. Therefore it is necessary to look for group B streptococcal infection in certain cases of diseases of the newborn. In a short review of literature the clinical signs (acute onset with respiratory distress, sepsis or late onset with meningitis), prevalence, source of infection and therapy (ampicillin or a combination of penicillin G and gentamicin) were summarized. The diagnosis is confirmed by isolation of group B streptococci.
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PMID:[Infections in newborn infants caused to B-streptococci]. 79 Aug 43

Fifteen newborns referred to the University of Utah Neonatal Intensive Care Unit (NICU) between 1971 and 1974 had septicemia and bronchopneumonia caused by streptococci of Lancefield group B. Eight of these infants could not be distinguished from others with idiopathic respiratory distress syndrome. All eight died and at autopsy were found to have bronchopneumonia. At autopsy, five of the ten subjects had bilateral pleural effusions. Eight of these early onset infections were caused by type III strains, three by type II strains, and four by Ia strains. The three survivors were infected by Ia organisms; two of these patients received antimicrobial therapy within one hour of birth and the other was treated at 20 hours of age. Among the 12 patients who died, six received no antibiotics and five were treated 12 or more hours after delivery. Earlier recognition may lead to more efficacious therapy of this most fulminant infection of the newborn.
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PMID:Pneumonia in the neonate associated with group B streptococcal septicemia. 79 Sep 40

A retrospective study involving all admissions to two neonatal intensive care centers over a 4-year period was carried out to assess the protective effect, or lack of it, of prolonged rupture of membranes (ROM) on the prevalence of idiopathic respiratory distress syndrome (IRDS) in premature infants. Significantly fewer cases of IRDS were found in patients in all gestational age groups when ROM was greater than 24 hours as compared with those with ROM of less than 12 hours' duration. However, prolonged ROM was not consistently associated with a difference in prevalence of respiratory failure accompanying IRDS, or in the prevalence of sepsis or neonatal mortality in this patient population. It is concluded that benefit to a premature infant in the form of reduced risk of developing IRDS is possible if the mother is allowed 24 hours after ROM before the delivery is initiated.
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PMID:Association of premature rupture of membranes with idiopathic respiratory distress syndrome. 83 98


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