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

An outbreak of influenza A/Victoria/3/75 (H3N2) involving five infants in a neonatal intensive care unit is described. The clinical signs and symptoms were indistinguishable from those seen in bacterial sepsis. There was no evidence of meningoencephalitis. All infants recovered without any sequelae.
J Pediatr 1977 Dec
PMID:Outbreak of influenza in a neonatal intensive care unit. 92 33

A method is described for the preparation of patients undergoing urologic procedures in which a segment of bowel is to be used to reconstruct the urinary tract. The combination of mechanical and antimicrobial preparation is effective in the sterilization of the bowel and the prevention of wound sepsis.
J Urol 1977 Dec
PMID:Preoperative bowel preparation in urologic surgery. 92 73

To examine further the role of immune-complex deposition in infective endocarditis, we studied 29 patients with infective endocarditis for presence of complement-containing circulating immune complexes. Ninety-seven per cent (28 of 29) had serum levels of immune complexes greater than 12 mug per milliliter. Mean levels in these patients were significantly higher than in patients with sepsis without endocarditis or in normal controls (P less than 0.05). Circulating immune-complex levels were correlated with longer duration of illness (P less than 0.025), extravalvular manifestations of endocarditis (P less than 0.025) and hypocomplementemia (P less than 0.05). Patients with right-sided endocarditis had significantly higher circulating immune-complex levels than patients with left-sided involvement (P less than 0.025). In general, levels fell to zero with successful antimicrobial or surgical therapy. This drop was concurrent with disappearance of extravalvular signs, blood cultures becoming sterile, and rise in serum complement levels. These findings support the concept that immune complexes may be important in the pathogenesis of infective endocarditis.
N Engl J Med 1976 Dec 30
PMID:Circulating immune complexes in infective endocarditis. 99 57

Septicaemia caused by Y. pseudotuberculosis in a female patient, aged 61, is reported. The patient suffered from amyloidosis with extensive infiltration of liver, spleen, and kidneys. While under treatment with corticosteroids and azathioprin, Y. pseudotuberculasis, serotype IA, was isolated from each of 6 blood cultures. The infection responded favourably to treatment with ampicillin. The development of Y. pseudotuberculosis septicaemia owing to impairment of the defence mechanisms by the underlying disease and the treatment given is discussed.
Acta Pathol Microbiol Scand B 1976 Dec
PMID:Yersinia pseudotuberculosis as the cause of septicaemia in a patient with amyloidosis. 99 63

Immunosuppressive agents are frequently used in transplant recipients for prevention of homograft rejection and in patients with leukemia for treatment of their primary disease. From 1973 to 1975, fifty-nine patients undergoing renal transplantation and forty-one patients with leukemia were treated at the University of California (Davis) Medical Center. Intestinal necrosis and perforation developed in four (7 per cent) of those receiving transplants and in four (10 per cent) of the patients with leukemia. One transplant receipient and all four patients with leukemia had extensive necrosis of both the small and large intestines. Two transplant recipients had isolated sigmoid perforations, and one had splenic flexure colonic perforation. All died from septicemia with septic shock. The etiology of these intestinal complication appears related to immunosuppressive agents, particularly high dosages of steroids. Despite the grave prognosis, early surgical intervention is the only method of dealing with these complications. Early diagnosis as well as properly timed and selected operations are necessary for the successful management of these patients.
Am J Surg 1976 Dec
PMID:Intestinal necrosis and perforation in patients receiving immunosuppressive drugs. 99 62

Sixty-three esophageal anastomoses were performed on adult patients with esophageal or gastric cancer. A total of thirteen anastomotic leaks occurred, resulting in death in seven patients and serious morbidity in an additional patients. Twelve patients had esophagocolostomy, with five anastomotic leaks. Four leaks occurred in the cervical region and were easily managed by local drainage and irrigation, while the other patient had an intrapleural leak resulting in sepsis and death. Twenty-eight patients had esophagogastrostomy, with a total of five leaks. All anastomoses were intrapleurally located, and death ensued in four patients. Fourteen Roux-en-Y and three loop esophagojejunostomies were performed, with no leaks. Two additional deaths occurred from leakage in the pleural cavity and left upper abdomen after jejunal interposition (3 patients) and esophagoduodenostomy (3 patients). In this study, impaired blood supply of the anastomotic end appeared to be the major cause of anastomotic failure. In addition, postoperative shock appeared to predispose to anastomotic leakage, whereas microscopic tumor at the lineof resection, duration of operation and operations for palliation did not appear to increase the leakage rate. The high mortality with esophageal anastomotic leak occurs when diagnosis is delayed and when the site of leakage is in the pleural cavity or left upper abdomen. Conservative treatment is uniformly fatal, whereas operative intervention offers the only chance for survival.
Am J Surg 1976 Dec
PMID:The esophageal anastomotic leak. 99 71

Experience with 28 patients with toxic dilatation of the colon is reviewed. The operative mortality in this series was 32% (9/28). Eight of the 9 patients who died were found to have colonic perforations at operation; in contrast, the group of patients with no perforations had a mortality rate of only 6%. Colonic perforation and sepsis were the most significant factors contributing to mortality and morbidity in this series. A review of the literature showed an overall operative mortality rate of 19.5% for patients with toxic megacolon; the mortality rate was 41% for patients with perforations and 8.8% for patients without perforations. It appears that the keystone to successful management is the avoidance of colonic perforation and sepsis; protracted medical management of toxic megacolon seems to have been at least partly responsible for these complications. Sixteen of the 18 survivors following subtotal colectomy required removal of the rectum within 9 months because of continued symptoms and disease in the rectal stump.
Ann Surg 1976 Dec
PMID:The surgical management of toxic dilatation of the colon: a report of 28 cases and review of the literature. 99 45

Of 92 patients with moderately severe acute pancreatitis initially studied within three weeks of onset by ultrasonic tomography, 52 developed an acute fluid collection in the lesser sac. Documentation of the ultrasound prediction of pseudocyst was achieved by surgery or autopsy in 26 cases. Spontaneous resolution of the acute pseudocyst was demonstrated by serial ultrasonography and radiogrphy in another 10 patients. Exploration exposed 3 false positive predictions of pseudocyst. Eleven other patients with a cystic configuration either refused surgery or were lost to followup. Acute pseudocyst formation is a relatively common phenomenon in the early phases of moderately severe pancreatitis. While spontaneous resolution of acute pseudocysts is frequent, in approximately 50% of cases acute pseudocysts progress to chronic pseudocysts. A distinction between acute and chronic pseudocyst is necessary since specific surgical management depends upon the phase of pseudocyst development. Unless regional sepsis supervens, acute pseudocyts of less than three weeks' duration may be followed by serial ultrasonography in the hope of spontaneous resolution. When a pseudocyst has achieved chronic status, spontaneous resolution is rare. Persistent conservative management under these conditions invites the excessive mortality and morbidity of spontaneous rupture.
Ann Surg 1976 Dec
PMID:Acute pancreatic pseudocysts: incidence and implications. 99 49

The prevalence of obligate anaerobes was studied prospectively in 60 patients with severe sepsis of intra-abdominal, soft tissue, female genital or oropulmonary origin. In addition, the efficacy of clindamycin (for anaerobes) plus gentamicin (for aerobic bacteria, especially coliforms) as initial empiric therapy in these patients was evaluated. Among 54 patients with cultural proof of infection, anaerobic pathogens were recovered from 52%. Nineteen patients had bacteremia; Bacteroides fragilis and Klebsiella pneumoniae were the most prevalent pathogens, being isolated in five patients each. Infection was eradicated in 56 of the 60 patients (93%). Mortality related to sepsis was 7% in the entire group, 16% in patients with bacteremia and 2% in patients without bacteremia. Eighty-five percent of aerobic isolates tested were susceptible in vitro to either gentamicin or clindamycin; 97% of anaerobic isolates were inhibited by 5 mug/ml of clindamycin.
Can Med Assoc J 1976 Dec 18
PMID:Clindamycin plus gentamicin as expectant therapy for presumed mixed infections. 100 Apr 57

In 140 patients with suspected intraabdominal abscess, studies were made using gallium-67 citrate and technetium-99m labeled radiopharmaceuticals. Gallium-67 scintigrams correctly localized 52 of 56 intraabdominal abscesses confirmed at surgical operation or necropsy. In an additional 20 patients in whom findings on scintigrams were abnormal, there were clinically established infections. Sixty-one patients in whom findings on scintigrams were normal were conservatively managed and discharged from the hospital; none proved to have an abscess. Four false-negative and three false-positive studies were recorded. Gallium-67 scintigraphy is a useful noninvasive diagnostic adjunct that should be employed early in the evaluation of patients with suspected intraabdominal sepsis.
West J Med 1976 Dec
PMID:Gallium-67 scintigraphy and intraabdominal sepsis. Clinical experience in 140 patients with suspected intraabdominal abscess. 100 46


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