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

Chest radiographs of 63 culture proven cases of neonatal septicemia were evaluated in this prospective study. Gram negative septicemia was responsible for 76.2% cases. Radiological abnormalities were observed in 27 cases (42.8%). Seven of these had no respiratory distress. The findings were right sided infiltrates (27%); hyperinflation (7.9%), bronchopneumonia (6.3%) and pneumothorax (1.6%). Increasing gestational age, late onset of illness (greater than 3 days) and presence of respiratory signs of distress had a positive correlation with presence of X-ray findings. Term newborns with respiratory distress of late onset sepsis (greater than 3 days) had significantly higher number (p less than 0.05) of abnormal radiographs. Presence of radiological abnormality neither influenced the clinical outcome nor was affected by the causative organisms. The practice of doing a chest radiograph routinely in cases of neonatal septicemia is justified irrespective of presence of respiratory signs of distress.
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PMID:Chest radiographs in neonatal septicemia. 142 36

A 12-month-old black female with an unremarkable past medical history was admitted to the hospital with respiratory distress and fever without identified sepsis. Despite mechanical ventilation, the patient died as a result of respiratory insufficiency secondary to severe necrotizing bronchitis and bronchiolitis with pneumonia. Electrophoretic and biochemical analyses of the patient's hemoglobin showed the patient to be a double heterozygote for hemoglobin C (a beta chain variant) and hemoglobin G-Georgia (an alpha chain variant). This is the first report of this combination of hemoglobin variants.
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PMID:Hemoglobin C--G-Georgia double heterozygosity: a case report. 145 31

Renal cortical necrosis, renal medullary necrosis, and combined renal cortical-medullary necrosis result from renal ischemia without vascular occlusion. Renal hypoperfusion and ischemic injury in infants have been ascribed to massive blood loss, hemolytic disease, septicemia, and severe hypoxemia. In a postmortem study we identified 82 cases among 1,638 autopsies during the 20 years between 1970 and 1989 in infants 3 months old or less at the time of death. The frequency of renal necrosis in autopsy cases increased significantly during the last 6 years of the study. The distribution of the renal lesion was cortical in 28, medullary in 23, and combined in 31. Forty infants carried diagnoses of congenital heart disease, 17 of asphyxial shock, 9 of sepsis, 3 of infectious myocarditis, 9 of major malformations, 4 of anemic shock, 1 of vascular malformation, and 1 of gastroenteritis and dehydration. A significantly higher proportion of babies with congenital heart disease had cortical involvement. Comparison of clinical characteristics revealed a significantly higher frequency of prematurity, respiratory distress syndrome, bleeding diathesis, and possibly sepsis in the children with congenital heart disease, suggesting that these factors are important in the pathogenesis of the renal lesion. Fourteen infants underwent cardiac catheterization; there was no demonstrable association between the renal lesions and the use of radiographic contrast medium. We conclude that severe congenital heart disease itself is a risk factor for life-threatening renal cortical and medullary necrosis.
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PMID:Renal cortical and renal medullary necrosis in the first 3 months of life. 148 35

The acute respiratory distress syndrome (ARDS) is a late complication in critically ill patients and its diagnosis is usually made when the syndrome is fully established. There is an increased interest in developing early markers that may help to identify ARDS in its initial stages. Calcitonin was recently reported as a useful serum marker to identify burned patients at risk for respiratory failure. We report a case with abdominal sepsis and ARDS, whose serum calcitonin level was 1000 pg/mL without other known clinical causes of hypercalcitoninemia and who died in multiorganic failure. The possible mechanisms of hypercalcitoninemia and its possible utility as marker of ARDS in critically ill patients is discussed.
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PMID:[Possible use of serum calcitonin in septic patients at risk of acute respiratory distress syndrome]. 148 35

A pilot study of the effect of exogenous surfactant (ES) on premature infants with respiratory distress syndrome (RDS) is reported. Each of the first 15 infants in this study received 200 mg/kg of natural surfactant (Curosurf) during the first day of life. Controls were 56 infants with RDS seen in the 15 months prior to the study. Within 5 minutes of starting ES, in all infants there was rapid and dramatic improvement in oxygenation and improvement in the average arterial/alveolar ratio of 169%. They had lower oxygen and ventilatory requirements than the control group throughout the first 5 days of life. No treated infant suffered from pulmonary air leak, while in the control group 21% developed pneumothorax and 11% had pulmonary interstitial emphysema. Mortality was 13% in the treated group as compared to 27% in the control group (p less than 0.01). There were no differences between the groups in the incidence of sepsis, patent ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage, or bronchopulmonary dysplasia, nor were there side-effects of therapy. Dosage, timing and composition of the ideal surfactant are important questions for future studies.
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PMID:[Surfactant replacement therapy for respiratory distress syndrome: a pilot study]. 150 35

A grave complication of sepsis is a respiratory distress in adult persons observed by the authors in 11.3% of the examinees. The syndrome of respiratory distress could develop in the presence of toxico-infectious (septic) shock or severe allergic immediate responses to the administration of certain drugs. The main approaches to the treatment of respiratory distress in adult septic patients turned to be glucocorticoids, heparin and recurrent sessions of hemosorption.
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PMID:[Adult respiratory distress syndrome in patients with infection]. 150 39

In a prospective study, 1156 blood specimens collected from hospitalized febrile obstetrical-gynecologic patients and neonates with suspected sepsis, were inoculated into a conventional biphasic culture medium, Castaneda S and cultures incubated aerobically. 15-24 h later the broth cultures were subcultured to specific media for detection of mycoplasmas. Genital mycoplasmas were isolated in 15 samples (taken from 8 women) and in 2 from 1 neonate. Mycoplasmas and members of the family Enterobacteriaceae were the most frequent significant bacteria isolated from adult specimens. Mycoplasma isolations were associated with either postpartum or postabortum febrile infections in women. Four of the neonates, whose mothers were infected, showed respiratory distress at birth; 1 of them had mycoplasmas in the blood. All febrile states in obstetrical or gynecological patients, and in neonates, should routinely lead to blood cultures for detection of mycoplasmas and ureaplasmas.
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PMID:Isolation of genital mycoplasmas from blood of febrile obstetrical-gynecologic patients and neonates. 150 36

Coagulase-negative staphylococci (C-NS) are a frequent cause of bacteraemia in premature neonates. It is likely that the strains of C-NS causing bacterial sepsis in premature neonates have their origin on the patient's skin surface. We have studied the quantitative development of the skin microflora at eight sites on premature neonates. A swab wash method was used to sample and enumerate the cutaneous microflora of premature neonates admitted to an intensive care unit with respiratory distress syndrome. The numbers of bacteria present on the skin increased rapidly by 100-fold in the first week of life. The species of C-NS found on neonatal skin were similar to those found on adult skin. However, the bacterial population was 10(3) lower by comparison. There was considerable variation in numbers of bacteria and in the proportion resistant to antibiotics from day to day. There appeared to be no association between antibiotic usage and the proportion of isolates resistant to antibiotics, although the resident bacteria were in many cases resistant to a variety of antibiotics. C-NS were isolated from 92% of samples from which bacteria were isolated. Staphylococcus epidermidis was found at all sites and accounted for 82% of each colonial type of staphylococcus isolated. Other organisms isolated included Propionibacterium sp, alpha-haemolytic streptococci, aerobic spore-bearing bacilli, aerobic coryneforms, Candida albicans, Klebsiella oxytoca, Pityrosporum sp, Klebsiella pneumoniae, and Escherichia coli. The results of this study suggest that the skin of premature neonates is colonised with antibiotic resistant C-NS during the first week of life and that the chance of contamination of an intravascular catheter at insertion increases during this period.
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PMID:Development of cutaneous microflora in premature neonates. 151 78

A comparative study of bowel colonisation and incidence of necrotising enterocolitis in neonates admitted to an intensive care unit is reported. Neonates of less than 33 weeks gestational age requiring mechanical ventilation for respiratory distress syndrome were randomised during the first week of life to receive either vancomycin and aztreonam or vancomycin and gentamicin for episodes of suspected sepsis after the first week of life. A higher proportion of neonates who received vancomycin and gentamicin had faecal colonisation with enterobacteriaceae at the end of the second, third, and fourth weeks of life. Treatment with vancomycin and aztreonam was associated with a rapid quantitative reduction in faecal colonisation with enterobacteriaceae, whereas there was no quantitative reduction in colonisation with enterobacteriaceae associated with treatment with vancomycin and gentamicin. There were no differences between the two groups in faecal colonisation with anaerobes, Enterococcus sp, Staphylococcus sp, or yeasts. Six (14.6%) of 41 who received vancomycin and gentamicin compared with 0 of 40 who received vancomycin and aztreonam subsequently developed necrotising enterocolitis.
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PMID:Enterobacteriaceae and neonatal necrotising enterocolitis. 153 88

Over a 4 year period, nine of 180 (5%) infants weighing less than 2000 G, admitted to the Aga Khan University Hospital (AKUH) developed necrotizing enterocolitis (NEC). An outbreak of NEC occurred in 1989, during which six infants developed the clinical illness. Overall incidence was 1.1%. Thirty-one birth weight and gestation matched controls were selected for comparison. Risk factors usually considered as predisposing factors, i.e., low 5 min Apgar score, rate of maternal complications, respiratory distress syndrome, mechanical ventilation, umbilical catheterisation, patient ductus arteriosus, use of antibiotics and feeding practices were found with equal frequency in both cases and controls. Six infants had positive blood and/or peritoneal fluid cultures (66%) compared to only five (16%) in the control group (P less than 0.01). Our data suggests that prematurity and sepsis are important predisposing factors for development of NEC.
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PMID:Necrotizing enterocolitis in infants weighing less than 2000 G. 157 65


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