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

We studied the clinical characteristics and the epidemiology of primary septicemia associated with Vibrio vulnificus in 70 patients. All patients came from the western and southern coastal areas of Korea. Most cases (96%) occurred during the summer months, in men (96%), and in persons 40 or more years of age (90%). The illness of 46 patients (66%) began with septicemia, often within 2 days of the consumption of raw seafood. Forty-seven patients (67%) had preexisting hepatic disease, and 49 (70%) had a history of alcoholism. Of the 70 patients, 45 (79%) died. The cutaneous lesions that were present on admission in 64 patients (91%) appeared on the legs in 51 of the cases. V. vulnificus was isolated from the blood of 65 patients tested and from the skin lesions of 51 of 55 patients tested. The histopathologic findings differed according to the clinical stage of lesions. Because V. vulnificus septicemia is a highly fatal disease, persons with liver disease or alcoholism should avoid eating or handling raw seafood.
J Am Acad Dermatol 1991 Mar
PMID:Vibrio vulnificus septicemia in Korea: clinical and epidemiologic findings in seventy patients. 158 Sep 1

Orofacial granulomatosis is a distinct clinical and pathological entity characterized by swelling of the lips and lower half of the face. Ulceration of the oral mucosa may also occur. Granulomas are seen histologically. Orofacial granulomatosis may occur in the Melkersson-Rosenthal syndrome, granulomatous cheilitis of Miescher, oral Crohn's disease, sarcoidosis and focal dental sepsis. The increased prevalence of atopy in patients with orofacial granulomatosis and the association with food intolerance suggests the possibility of a role for allergy in at least some cases.
Clin Exp Dermatol 1990 Sep
PMID:Orofacial granulomatosis associated with delayed hypersensitivity to cobalt. 222 46

Toxic epidermal necrolysis is perhaps the most formidable disease encountered by dermatologists. Uncommon but not rare, toxic epidermal necrolysis occurs in 60 to 70 persons per year in France. It remains as puzzling a disorder as it was 34 years ago, when described by Lyell. Whether or not toxic epidermal necrolysis is the most severe form of erythema multiforme is still the subject of discussion. The physiopathologic events that lead to this rapidly extensive necrosis of the epidermis are not understood. Indirect evidence suggests a hypersensitivity reaction, but the search for potential immunologic mechanisms has resulted in little data to support this hypothesis. Accumulated clinical evidence points to drugs as the most important, if not the only, cause of toxic epidermal necrolysis. Sulfonamides, especially long-acting forms, anticonvulsants, nonsteroidal anti-inflammatory agents, and certain antibiotics are associated with most cases of toxic epidermal necrolysis. Many other drugs have been implicated in isolated case reports. All organs may be involved either by the same process of destruction of the epithelium as observed in the epidermis or by the same systemic consequences of "acute skin failure" as seen in patients with widespread burns. Sepsis is the most important complication and cause of death. Approximately 20% to 30% of all patients with toxic epidermal necrolysis die. Elderly patients and patients with extensive lesions have a higher mortality rate. Surviving patients completely heal in 3 to 4 weeks, but up to 50% will have residual, potentially disabling ocular lesions. The prognosis is improved by adequate therapy, as provided in burn units, that is, aggressive fluid replacement, nutritional support, and a coherent antibacterial policy. Corticosteroids, advocated by some in high doses to halt the "hypersensitivity" process, have been shown in several studies to be detrimental and should be avoided.
J Am Acad Dermatol 1990 Dec
PMID:Toxic epidermal necrolysis (Lyell syndrome). 227 3

A 31-year-old Hispanic man presented in the pancytopenic phase of acute myelocytic leukemia and was treated with the chemotherapeutic agents mitoxantrone and cytarabine. After 5 days, an erythematous, blanching, papular, crusted eruption developed on his forehead, chest, and legs. Some lesions showed confluence and all were at the same developmental stage. Clinical diagnoses included necrotizing vasculitis and sepsis. A biopsy specimen revealed widespread noninflammatory syringometaplasia of eccrine ducts. Well-developed intercellular bridges and eosinophilic cytoplasm were seen within the metaplastic cells; apoptoses and occasional mitoses were present. This process is distinct and probably occurred secondary to direct toxic injury from the chemotherapeutic drugs. Because similar changes have occurred in patients with neutrophilic eccrine hidradenitis, we believe our patient represents an example of the noninflammatory end of the spectrum of chemotherapeutic eccrine gland reactions.
Arch Dermatol 1990 Jan
PMID:Eccrine squamous syringometaplasia. A cutaneous sweat gland reaction in the histologic spectrum of 'chemotherapy-associated eccrine hidradenitis' and 'neutrophilic eccrine hidradenitis'. 240 65

The myeloperoxidase-hydrogen peroxide-chloride (MPO-H2O2-Cl) system is an antimicrobial system of polymorphonuclear leukocytes. We demonstrated that the MPO-H2O2-Cl system is fungicidal for Trichophyton rubrum. Fungal growth of a synchronous cell culture of T. rubrum germlings was assayed by measuring the uptake of tritiated N-acetyl-D-glucosamine, and the viability of the fungi was assayed by counting colony-forming units. Cytotoxins produced by the interaction of myeloperoxidase with hydrogen peroxide and chloride ion were fungicidal for T. rubrum. Growth inhibition was abolished in the presence of catalase or L-methionine. Polymorphonuclear leukocytes through the MPO-H2O2-Cl system may prevent invasion and sepsis by dermatophytes even in the absence of specific immunity.
J Invest Dermatol 1989 Apr
PMID:Inhibition of growth of Trichophyton rubrum by the myeloperoxidase-hydrogen peroxide-chloride system. 253 15

Dapsone has been suggested as a useful drug in the treatment of granuloma annulare; however, adverse reactions include a potentially life-threatening agranulocytosis. We report the case of a 50-year-old woman in whom agranulocytosis and septicemia developed after 7 weeks of therapy with dapsone for granuloma annulare. Full recovery followed cessation of this drug, but caution is advised in prescribing dapsone for relatively benign skin conditions.
J Am Acad Dermatol 1989 Jan
PMID:Agranulocytosis caused by dapsone therapy for granuloma annulare. 264 42

This paper recalls the notable achievement, in 1880, of Alexander Ogston, a surgeon who, seeking the cause of suppuration, showed that acute abscesses result from micrococci. There were two kinds. One, arranged in chains, had been called streptococci already; the other, in clumps, he named staphylococci. He injected micrococci into animals. If blood poisoning occurred in them, it followed localized tissue infection. This information, applied to surgical events, suggested that the "hospital diseases" were a sequel to wound suppuration and explained why antiseptic surgery controlled both conditions. Ogston's observations are now common knowledge, but Lister rejected them. It is suggested he did so because he relied on intuition rather than experiment. The scene is set for Lister and Ogston's discoveries by a review of the historical background. Patients subjected to surgery faced a terrible ordeal and a very real chance of death from the mysterious hospital diseases. Surgeons viewed the mortality with bland detachment, blaming fate. But Simpson and Semmelweis were deeply concerned. However, puerperal fever was regarded as entirely distinct from the hospital diseases, and neither condition connected in any way with suppuration in wounds. Simpson, Semmelweis, Lister, and Ogston all found their ideas scorned by members of the profession, which may have feared being held responsible for deaths. Ogston's achievement lives on, but he has been forgotten. We should remember him.
J Am Acad Dermatol 1989 Feb
PMID:Alexander Ogston, micrococci, and Joseph Lister. 264 19

Natural killer (NK) cell activity was evaluated in 34 patients with inherited forms of epidermolysis bullosa (EB). While the NK activity of EB simplex patients did not differ from that of control subjects, persons with more severe forms of EB demonstrated significant reductions in NK activity. The degree of this reduction was directly related to the severity of the skin involvement by EB with recessive dystrophic EB patients having the lowest NK activity. The absolute number of cells bearing NK surface markers in the peripheral blood of patients with recessive dystrophic EB did not differ from that of normal control subjects. This reduced NK activity may be at least partially responsible for the occurrence of septicemia in some persons with severe forms of EB and for the development of metastatic squamous cell carcinoma in patients with dystrophic EB.
Arch Dermatol 1989 Jun
PMID:Natural killer cell activity is reduced in patients with severe forms of inherited epidermolysis bullosa. 273 Jan

A 68-year-old Japanese woman with sepsis developed a gangrene on her left cheek from a small wound in contact with a gastric tube. Klebsiella pneumoniae was cultured from the sputum, wound, and the blood and was assumed to be responsible for this condition, possibly through thrombosis of an artery.
J Dermatol 1989 Jun
PMID:Bacterial gangrene on the cheek of a comatose patient--necrotizing fasciitis or noma. 279 26

Dysgonic fermenter type 2, a gram-negative bacillus that is part of the normal oral flora of dogs and cats, is responsible for increasing numbers of cases of fulminant septicemia in humans. Patients usually have preexisting medical illnesses, but infection also occurs in otherwise healthy individuals. Most infections are acquired through animal contact. Dermatologic eruptions occur in half of the patients with dysgonic fermenter type 2 infection, and include petechiae, purpura, cellulitis, and gangrene.
Arch Dermatol 1989 Oct
PMID:Dysgonic fermenter type 2 septicemia with purpura fulminans. Dermatologic features of a zoonosis acquired from household pets. 280 46


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