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

A 3-month-old infant being treated for bronchitis developed a rapid onset but otherwise typical orbital cellulitis. Because gram-negative infections and septicemia are common occurrences in the newborn nursery, this patient was given systemic gentamicin and ampicillin. Sinus x-rays were not attempted. Two days after treatment the eyelids were opened. A strikingly large corneal ulcer with perforated globe and endophthalmitis was found. Pseudomonas aeroginosa was cultured from the blood, conjunctiva, and throat. A diagnosis of Pseudomonas orbital cellulitis with secondary corneal perforation and endophthalmitis was made. The source of infection was believed to be the respiratory tract.
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PMID:Pseudomonas orbital cellulitis. 10 5

A 3-year experience with 50 acute renal failure patients managed by hemodialysis in a 417-bed community hospital is reviewed. The 58% survival rate was better than that reported in other recent series. Possible reasons for our favorable mortality experience include: (1) Hemodialysis was performed within the ICU facility by the ICU staff. Continuity of total care was thereby maintained and hemodialysis problems, such as maintenance of circulating volume, were managed in the context of continued assessment of the patient's cardiopulmonary status. (2) In contrast to previous reports, the presence of sepsis did not influence recovery rates from acute renal failure. Early administration of specific antibiotics, mainly gentamicin, rapid drainage of abdominal abscesses, and early and frequent dialysis were all utilized in spetic patients and may have contributed to their high recovery rate. (3) The use of agressive dialysis may also have lessened other uremic complications, notably gastrointestinal bleeding. Our dialysis organization and procedures are described.
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PMID:Acute renal failure. Community hospital experience with hemodialysis as intensive care adjunct. 86 9

Because sepsis is characterized by a depression in vascular reactivity, we hypothesized that changes in organ blood flows (Q) would differ between the nonseptic and septic state during the infusion of sympathomimetics. Therefore we examined the (sepsis x organ Q) interaction during the infusion of five sympathomimetics in 36 mature, awake sheep before and after cecal ligation and perforation produced hyperdynamic sepsis. A 3-hour infusion of dobutamine, norepinephrine, dopamine, dopexamine, or salbutamol was compared with that of placebo during both nonseptic and septic studies; drug infusion was titrated to an increase in cardiac index of greater than 20%. Increased plateau infusion doses of norepinephrine (+305%), salbutamol (+275%), dopamine (+70%), and dobutamine (+49%) were required to achieve predefined treatment guidelines during the septic versus nonseptic study. Few differences in the regional effects of individual sympathomimetics were found in the nonseptic study, although infusion of sympathomimetics was accompanied by a redistribution of systemic Q toward the heart and away from the brain, kidney, small intestine, liver, and pancreas. In the septic study, however, the sympathomimetic infusions were not accompanied by the redistribution of Q away from small intestine and liver that was demonstrated in the nonseptic study. Therefore (1) the depressed vascular reactivity in hyperdynamic sepsis altered the dose profile of exogenous sympathomimetics required to augment systemic Q, and (2) the (sepsis x sympathomimetic) interaction was characterized by a depression in the anticipated redistribution of organ Q from "nonvital" to "vital" circulations.
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PMID:The effect of various sympathomimetics on the regional circulations in hyperdynamic sepsis. 151 72

We report the first known case of daunorubicin administered directly into the human central nervous system. A 3 1/2-year-old female with pneumonia and otitis media was diagnosed with acute lymphoblastic leukemia and was admitted for antibiotics and chemotherapy. On the first day she inadvertently received a 17 mg intrathecal (IT) injection of daunorubicin. When the error was recognized about 1 hour later, her cerebrospinal fluid (CSF) was exchanged with sterile saline by barbotage, IT hydrocortisone was given, a subarachnoid catheter was inserted, and the CSF was allowed to drain for 36 hours. Only 5.6 mg (33%) of the dose was recovered from CSF, 2.7 mg as daunorubicin and 2.9 mg as the metabolite, daunorubicinol. Initially she was asymptomatic and induction therapy continued with vincristine, 1-asparaginase, prednisone, and IT methotrexate. One week after the daunorubicin injection she developed headache and irritability; CSF protein was 3.2 gm/dl. On the 12th day, she developed fungal sepsis and worsening pneumonia. On the 15th day, she became comatose with a flacid paraparesis, areflexia, and an ascending progressive bulbar palsy. A series of computerized tomography scans over 6 weeks showed increasing diffuse cerebral atrophy. Nerve conduction velocity studies were consistent with an axonal neuropathy. Despite her multiple concurrent medical problems, the timing and characteristics of neurologic damage suggest that IT daunorubicin caused progressive destruction of the nervous system.
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PMID:Inadvertent intrathecal injection of daunorubicin with fatal outcome. 157 39

A 3-day-old Quarter Horse colt was examined because of signs of severe depression, discomfort, and abdominal straining. The foal seemed disoriented, and the abdomen was tense and distended ventrally. The differential diagnoses included ruptured urinary bladder, retained meconium, septicemia/bacteremia, and neonatal maladjustment syndrome. Serum biochemical analysis revealed marked hyponatremia, hypochloremia, and moderate hyperkalemia, as well as mildly high urea, creatinine, and phosphorus concentrations. The primary differential diagnosis at this time was ruptured urinary bladder. Abdominocentesis was performed to confirm this diagnosis. Microscopic examination of abdominal fluid revealed calcium carbonate crystals, which originated from the urine of the foal. Biochemical analysis also confirmed the diagnosis of ruptured urinary bladder, because the ratio of peritoneal fluid creatinine to serum creatinine was 2.8:1. The foal died before surgical correction could be attempted.
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PMID:Diagnosis of ruptured urinary bladder in a foal by the identification of calcium carbonate crystals in the peritoneal fluid. 161 90

It has been postulated that biliary infection plays a role in bile duct stricture formation. The aim of this study was to verify this hypothesis and to evaluate the effect of biliary infection on common bile duct healing. A 3-mm longitudinal choledochotomy was performed in 120 rats and closed with a continuous 11/0 Ethilon suture. Common bile duct division with end-to-end anastomosis using interrupted 11/0 Ethilon sutures was performed in another 30 rats. Biliary infection was achieved in half of the animals with retrograde injection of living 046:K1:H31 strain Escherichia coli recovered from the rat colonic content. All rats with choledochotomy, including those with biliary infection, showed no bile leakage at the suture line, and the bursting pressure at the site of choledochotomy exceeded 40 mmHg as early as 24 h. Rats with common bile duct anastomosis alone showed no stricture formation for up to 6 months after operation. All rats with biliary sepsis developed complete occlusion at the anastomosis. On scanning electron microscopy, the biliary epithelium was well preserved in all rats. The study suggests that in rats with biliary sepsis the risk of bile leakage after primary closure of the common bile duct is negligible, but biliary infection may play a critical role in common bile duct stricture formation.
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PMID:Effect of biliary infection on common bile duct healing in the rat. 176 Jun 96

A 3-month old female infant was transferred from another hospital where she had been hospitalized from the age of 1 month for protracted secretory diarrhea. The diarrhea had begun at birth and was unresponsive to various therapeutic formulas and to total parenteral nutrition (TPN). The parents were consanguineous. There were 6 normal siblings, while 3 siblings had died in infancy, including a sister who had succumbed to protracted diarrhea at the age of 6 months. In our patient duodenal biopsy showed flattening of villi and proliferation of mononuclear cells in the lamina propria. Specific circulating IgG antibodies against gut epithelium were found, as well as thyroglobulin antibodies. Repeated trials of oral feeding were unsuccessful and TPN was required for 8 months. Complications included septicemia, osteomyelitis and acute renal failure. Therapeutic trials with intravenous hydrocortisone, zinc sulphate and metronidazole were unsuccessful and the infant died at the age of 11 months. Intestinal tissue taken postmortem showed nearly absolute flattening of intestinal villi. This is the first report in Israel of intractable infantile diarrhea due to autoantibodies to intestinal epithelium.
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PMID:[Autoimmune enteropathy causing protracted diarrhea]. 235 45

A 3-year-old girl is reported on who underwent laparotomy for ileocaecal intussusception elsewhere one week following severe gastroenteritis. Immediately after surgery, she developed haemolytic-uraemic syndrome with haemolytic anaemia, thrombocytopenia, increase of urea and creatinine and anuria as well as subsequent peritonitis, enterocolitis and sepsis. Following relaparotomy with establishment of ileostomy, peritoneal dialysis for several days was carried out for treatment of the haemolytic-uraemic syndrome. This case demonstrates that the haemolytic-uraemic syndrome can be treated effectively by peritoneal dialysis despite fresh bowel anastomoses, and that simultaneously occurring peritonitis can be managed by intraperitoneal administration of antibiotics via dialysis fluid.
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PMID:[Peritoneal dialysis in hemolytic-uremic syndrome following ileocecal resection for invagination in postoperative peritonitis]. 275 Mar 44

A 3-month-old girl presented to the emergency department with a clinical picture compatible with sepsis. When peripheral IV cannulation could not be attained, intraosseous (IO) access was attempted unsuccessfully in both tibias as well as in the right femur. The child was subsequently treated for S pneumoniae meningitis. Three days after discharge and 14 days after initial presentation, the family noticed swelling of the child's right leg. Radiographs revealed healing fractures of both proximal tibias. This case represents a previously unreported complication of intraosseous infusions and underscores the need for the use of proper technique and equipment.
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PMID:Iatrogenic bilateral tibial fractures after intraosseous infusion attempts in a 3-month-old infant. 238 80

Between September 86 and May 87 we reviewed the case histories of 25 newborns (gestational age: 33-41 weeks, birth weight: 1280-3600 g) with septicaemia proved by positive blood cultures. Two groups are formed: Group A: onset of sepsis within the first 48 hours of life (10 newborns), group B: onset of sepsis after 48 hours of life (15 newborns). No differences in gestational age and birth weight were found between the groups. Amnionitis was found in 8 mothers (80%) of group A, however, we found only 2 (13%) mothers with amnionitis in group B. All patients in group A had signs of the respiratory distress syndrome and their clinical condition was poor. Only the CRP was helpful in the laboratory diagnosis of septicaemia. In group B sepsis was diagnosed in 11 (73%) patients by means of a raised CRP and an increased immature neutrophil count. Only 4 patients of this group showed clinical deterioration. The following bacteria were cultured: Group A: E. coli 4, b-streptococci 3, Klebsiella 3. Group B: Staph, aureus 8, Strept. faecalis 5, Pseudomonas 2. In group A 3 patients died and 3 patients developed meningitis with neurological sequelae. In group B non of the patients died, but 2 patients developed osteomyelitis.
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PMID:[Prognostic significance of the onset of infection in newborn infants]. 318 29


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