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

A retrospective survey of 100 lower limb amputations performed for ischaemia were analysed to assess the influence of preoperative bacterial isolates and the use of prophylactic antibiotics on wound sepsis. Forty-eight per cent had previously undergone a vascular procedure to attempt limb salvage and 17% were diabetics. Benzylpenicillin was given preoperatively and continued for 5 days; diabetics received metronidazole in addition. A total of 51 isolates were obtained from 30 patients preoperatively; Staphylococcus aureus and Enterobacteriaceae each accounted for over 25%. Postoperatively, 74 isolates (20 multiple) were obtained with an overall sepsis rate of 40%. Those patients with a positive preoperative culture were significantly more likely to develop wound sepsis. There was no significant difference in wound sepsis rates for diabetics. In view of the range of organisms causing postoperative infection, we recommend prophylaxis with a broad spectrum antibiotic for amputations.
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PMID:A bacteriological survey of amputation wound sepsis. 257 8

Among 829 consecutively treated neonatal intensive care patients during the years 1985 and 1986 46 cases of early onset type an 14 cases of late onset type (beyond the 4th day of life) of sepsis neonatorum were diagnosed. Mortality was 20%. In 40% of the cultures penicillin-resistant staphylococcus epidermidis was found. It was resistant to Penicillin however fully sensitive to Cefamandol, Netilmycine and Amicacine. Primary therapy of early onset type of sepsis has to be effective against Streptococci and against Listeria monocytogenes. Blood culture is the only way to proove or to exclude sepsis at a rational way. Good hospital hygiene can prevent a part of late onset type of sepsis. Immuntherapy is regarded as an import part of Sepsistherapy in the newborn.
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PMID:[Observations on neonatal infection]. 318 65

Dysgonic fermenter 2 (DF-2) is a slow-growing gram-negative bacillus causing a zoonotic infection that is acquired through dog bites or other contact with dogs. Splenectomized patients and those with alcoholic liver disease are most susceptible to DF-2 infection. The clinical picture can be one of fulminant septicemia and disseminated intravascular coagulation in the splenectomized patient; the presentation is milder in the alcoholic patient. The overall mortality from DF-2 septicemia among the 41 cases reported in the literature is 27%. The organism is sensitive to penicillin, resistant to aminoglycosides, and not easily grown on common media. It appears to be serum-sensitive in tests with normal human serum. Penicillin prophylaxis of dog bite wounds is especially important in high-risk patients. DF-2 infection should be considered when any splenectomized patient develops fulminant septicemia, disseminated intravascular coagulation, and peripheral gangrene. Examination of a gram stain of the peripheral blood or buffy coat is of value in such cases.
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PMID:Dysgonic fermenter 2 septicemia. 331 33

The vital role of a normally-functioning spleen in a host's defence against circulating microorganisms has been realized for many years. The fulminant clinical course that characterizes infection with encapsulated microorganisms in asplenic patients is highlighted in these cases of severe pneumococcal sepsis in two patients, 10 and 13 years after splenectomies for idiopathic thrombocytopenic purpura. Approaches to the acute management of septic episodes and preventive measures are discussed. Pneumococcal vaccination reduces the incidence of infection effectively in asplenic patients and has a low complication rate. Penicillin by mouth is also efficacious in this situation, but patient compliance is low. Our current practice is to offer pneumococcal vaccination to all patients who have undergone splenectomy in the past and to administer the vaccine two weeks before elective splenectomies. Asplenic patients should be educated about the potential dangers of a septic episode and should be urged to seek an early medical consultation when this occurs.
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PMID:Fulminant postsplenectomy sepsis. 333

Dysgonic fermenter 2 (DF-2) is a fastidious, gram-negative organism well recognized as a cause of fulminant septicemia in patients without spleens or patients with alcoholic cirrhosis. In vitro antibiotic susceptibility testing of eight strains with a Schaedler broth dilution technique revealed DF-2 to be susceptible to all of the antibiotics tested except aztreonam. Previous reports that DF-2 is aminoglycoside resistant were based on disk diffusion or agar dilution assays that may be less reliable given the slow growth of the organism and its requirement for CO2 incubation. Penicillin is commonly used as prophylaxis after dog bites and has excellent activity against DF-2.
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PMID:Susceptibility of dysgonic fermenter 2 to antimicrobial agents in vitro. 334 15

A fusobacterium necrophorum septicemia due to a neglected peritonsillar abscess is reported in a 7 year-old boy with no significant past medical history. Osteo-articulary, hepatic and pleuro-pulmonary septic localizations, with an otherwise favourable outcome left severe orthopedic sequelae in the right hip. This resembles the post-peritonsillar abscess septicemia described by Lemierre in 1936 which was due to an anaerobic bacillus (fusobacterium). The reappearance of this pathology should lead to systematic anaerobic blood and abscess studies. Penicillin G and Metronidazole are still efficient in controlling this organism.
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PMID:[Post-angina septicemia caused by Fusobacterium necrophorum in a 7-year-old child]. 346 89

Nine cases of pleuro-pulmonary infection due to Pasteurella multocida were observed over an 11 year-period (1974-1984) occurring in seven men and two women, with a mean age of 65 (range: 47-80 years). There were 4 pneumonias and 5 cases of empyema, occurring on three occasions after septicemia. There was a background of depressed immunity in 7 cases: alcoholic cirrhosis (4 cases), blood dyscrasias (2 cases), breast cancer (1 case); and of a chronic broncho-pulmonary pathology in two cases. Animal inoculation was present in six cases but only one case of pneumonia followed injury by an animal (cat scratch). The clinical, radiological and epidemiological data of these nine cases were similar to those in the literature (forty-five published cases). There was a zero mortality in our (from 30%) in the literature. Pasteurella multocida is an opportunistic organism, noncommensal in man, producing pulmonary infections in subjects with generalised or localised diminished resistance, the portal of entry being airborne (indirect animal contact) or haematogenous. The organism is nearly always sensitive to Penicillin and other B-lactamines. The gravity of infections to Pasteurella multocida relates to the degree of decompensation or severity of the underlying disorder.
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PMID:[Pleuropulmonary disease caused by Pasteurella multocida. Study of 9 cases. Review of the literature]. 378 27

Septicemia caused by anaerobic bacteria is indistinguishable from septicemia caused by aerobic bacteria. High age, origin in the gastrointestinal or genitourinary tract, malignancies and surgery or invasive, diagnostic procedures are indicative of anaerobic etiology. Between 5% and 15% of all septicemias are anaerobic. Benzylpenicillin is active against most anaerobic bacteria, and nitroimidazoles, clindamycin and chloramphenicol are dependable drugs in the treatment of bacteroides septicemias. Surgical drainage and debridement are of major importance, and proper measures to prevent circulatory failure are mandatory. Hyperbaric oxygen therapy may have a dramatic effect. The use of corticosteroids and endorphin antagonists is controversial. Exchange transfusions have been attempted, but further clinical trials are necessary to establish their place in the management of anaerobic septicemia.
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PMID:Treatment of anaerobic septicemia. 386 56

TWO HUNDRED CASES OF INTRACRANIAL SUPRATENTORIAL ABSCESS HAVE BEEN REVIEWED: 100 spanned the years 1951 to 1957, and 100 the years 1962 to 1967. The mortality rate of 40% was the same in both series, chiefly owing to continuing inaccurate localization of the abscess and inadequate use of antibiotics. The hazards of lumbar puncture are real, and this procedure is contra-indicated when convulsions, signs of a hemisphere disturbance, or papilloedema are present. Of the methods for localizing intracranial abscess the site of E.N.T. sepsis, ventriculography, and brain scanning were found to be the most valuable. Penicillin in high dosage continues to be the most important antibiotic. The results of assiduously repeated burrhole aspiration compare favourably with those of later excision.
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PMID:Management of supratentorial intracranial abscess: a review of 200 cases. 530 85

Eleven hundred and sixty eight traumatic cases have been operated on under constant conditions in a conventional operating room with filtered air and positive pressure using absolute filters of 99.999 efficiency. Two hundred and five were submitted to post-operative prophylactic administration of Cephalosporin (Cefazolin) for 2 days. The overall results showed 0.6 p. 100 of infection but 4 cases of severe sepsis were seen in the group of patients who had received prophylactic antibiotics. The authors have compared these results with those obtained during the previous period when the operating room was less modern. They conclude that this factor is of paramount importance. On the other hand, they have observed 2.1 p. 100 of contaminated drains without subsequent infection. They are concerned at the increase of gram-negative organisms resistant to Cefazolin (60 p. 100) and of Staphylococci resistant to Methicillin (30 p. 100). They conclude that the peroperative flash technique of the administration of Penicillin M is worthwhile.
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PMID:[Postoperative infectious risk in traumatic bone surgery and protocol for antibiotic therapy]. 623 25


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