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

The effects of season and variations in the prevalence of infectious disease on the concentrations and daily production of breast-milk immunoproteins were studied in 152 rural Gambian mothers and their children up to 26 months post-partum. IgA, IgG, IgM, C3, C4, lactoferrin, lysozyme and secretory component concentrations and breast-milk volumes were measured longitudinally over a six month period which encompassed dry and rainy seasons. No increase in the production of any immunoprotein was observed at the time of maximum prevalence of serious infectious diseases, especially diarrhoea, in the children. Enhanced secretion of certain immunoproteins was noted in mothers of children aged 9-18 months at the beginning of the rainy season. There was some evidence that this may have been associated with skin sepsis, particularly impetigo, in the children. The production of most immunoproteins fell during the rainy season. This was not the result of declining maternal food intakes as similar decreases were seen for women receiving a dietary supplement.
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PMID:Breast-milk antimicrobial factors of rural Gambian mothers. II. Influence of season and prevalence of infection. 654 89

The immune system was studied in 30 cases of local infection (pneumonia) and 56 cases of generalized infection (sepsis). Predominantly children with immunologic deficiency of the humoral type (77% of the cases) characterized by unscheduled fatty transformation of the thymus, underdevelopment of B-zones of lymphoid organs, low level of IgM production and the lack of IgG and IgA production were found to die with pneumonia, whereas children with physiological immaturity of the immune system and in smaller numbers (41% of the cases) with deficiency of immunity of the cellular and phagocytic type as confirmed by immaturity of the thymic tissue or its dysplasia with hypoplasia of lymphoid organs died with sepsis. Immunological deficiency of the humoral type is accompanied by suppurative destructive lesions of the respiratory organs, immunodeficiency of the cellular and phagocytic type by necrotic changes in the septic focus and mucous membranes of the organs contacting the environment.
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PMID:[The immune system and its relation with infection process in children]. 660 38

Despite major diagnostic and therapeutic advances, postoperative peritonitis appeared to be still associated with a severe prognosis. The failure to react to delayed hypersensitivity skin tests was recently shown to identify patients at increased risk for sepsis. In an attempt to clarify the mechanisms of this anergy, cellular and humoral immunity was studied with in vitro tests in 12 patients treated for postoperative peritonitis. Complement was decreased in 33.3% of cases and normal in the others. No significant change was found in IgG and IgM titres, but IgA concentrations were increased in 80% of cases. A decrease in the total number of lymphocytes was observed in 41.7% of patients, related to the reduction in the total T lymphocyte count. Mitogen-induced lymphocyte transformation was studied with phytohaemagglutinin, concanavalin A, pokeweed-mitogen, and tuberculin purified protein derivative. Six patients had decreased or negative response to at least three mitogens; 91,7% had no response to tuberculin. The leukocyte migration inhibition test was negative in all cases. These abnormalities in cell mediated immunity may have been related to underlying diseases (severe nutrition depletion in 7 cases), to sepsis (septic shock in 10 cases), to repeated anaesthesias and surgical procedures, and even to drugs (e.g. antibiotics). The presence of serum inhibitors may have been the cause of the anergy and further studies are required.
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PMID:[Immune disorders during postoperative peritonitis]. 671 18

Levels of antibodies to the capsular polysaccharides of groups A and C Neisseria meningitidis and Haemophilus influenzae type b were determined by radioimmunoassay in acute- and convalescent-phase sera of 377 patients with meningitis, septicemia, or epiglottitis. Diagnostic criteria, based on a fourfold or greater rise in antibody level and/or a high specific antibody level, correctly identified 85% of group A meningococcal diseases, 90% of group C meningococcal diseases, and 78% of H. influenzae type b diseases in children older than but only 15% in infants younger than 1.5 years of age. When levels of antibody in acute-phase sera were high, they were predominantly of the IgA class. A greater than fourfold rise in levels of antibodies to group A meningococcus was seen in 10%-32% of persons with disease caused by other bacteria, but minimal false-positive reactions occurred with group C meningococcus or H. influenzae type b.
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PMID:Antibody response to capsular polysaccharides of groups A and C neisseria meningitidis and Haemophilus influenzae type b during bacteremic disease. 678 3

161 children followed up postoperatively following splenectomy, 29% had spherocytosis, 14% Hodgkin's disease, 12% traumatic rupture of the spleen, 11% portal hypertension and 7% idiopathic thrombocytopenia. Postoperatively a slight wound infection occurred in 5% of the children, while complications were seen in 2% which could be interpreted as directly caused by the operation; in 23 patients, however, (i.e. 15%), severely infections occurred such as pneumonia, meningitis and sepsis. The lethality rate of the infected children was 31.8%. Postoperatively we determined the leucocyte count, thrombocytes and erythrocyte count, the immunoglobulins IgG, IgA, IgM and IgE, the serum concentrations of the complement components C3, C4 and the serum proteins alpha 1-antitrypsin and transferrin. The data obtained were compared with the corresponding data reported in the literature.
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PMID:[Complications of splenectomy in childhood (author's transl)]. 704 92

Immunological function was examined in children who had undergone splenectomy, in 8 for trauma, and in 11 for haematologic/oncologic reasons. Particular emphasis was placed on the effects of residual splenic tissue on immune function. Children in the elective group had no evidence of splenosis but 6 of the 8 trauma patients showed residual splenic activity. A general trend indicated that immunological dysfunction was associated with the presence of residual splenic tissue. Three patients with significant post-traumatic splenosis showed low IgM levels, one also had a low IgG level and another a low IgA and impaired lymphocyte response to mitogens. The trauma patients with little or no splenic tissue had normal immune functions. Immunological abnormalities were found in 8 of the 11 haematologic/oncologic patients with no splenosis suggesting the abnormalities were possibly due to the primary disease. In contrast to the popular belief that splenosis confers protection against overwhelming sepsis, the present findings suggest that patients with residual splenic tissue are at a greater risk of infection because of a lower level of immune response.
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PMID:Immune dysfunction in the presence of residual splenic tissue. 710 43

Splenectomy results in loss of about 1/4 of the reticulo-endothelial system and 1/3 of the lymphatic tissue. Reduced phagocytosis and "clearing" capacity are reflected in the appearance of Howell Jolly bodies, thrombocytosis and decreased circulating immune-complexes. Reduction of IgM and compensatory increase of IgG and IgA levels further indicate immunological impairment. Transitory reduction of complement activity and the number of T-lymphocytes in the first weeks post-splenectomy constitute a significant limitation of immunological function and are accompanied by low serum tuftsin levels. These factors help explain the increased susceptibility to overwhelming infection seen in splenectomized patients. The lethality rate due to sepsis has been reported to be as high as 50%. Patients with hematological disorders, with systemic malignancies and children under 4 years of age who undergo splenectomy because of abdominal trauma are at especially high risk. The most common infectious agents are Haemophilus influenzae and Pneumococcus. The present report describes 2 infants who underwent splenectomy for the treatment of splenic rupture due to birth trauma. In one case, splenic tissue was homogenized and re-implanted; in the second case, splenectomy was followed by penicillin prophylaxis. The clinical course in the latter patient was complicated by Candida meningitis.
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PMID:[Should splenic tissue be re-implanted after splenectomy due to birth trauma?]. 713 20

In order to explain complement components abnormalities observed during septic shock, circulating immune complexes (C.I.C.) were searched for in sera from 34 patients with gram negative sepsis by two different methods: polyethylene glycol precipitation test based on physical properties of C.I.C. and C1q deviation test based on the property of radiolabelled C1q to react with C.I.C. Serum immunoglobulins (IgG, IgA, IgM) and complement components (C1q, C3, C4) levels were simultaneously determined. Seventeen patients with minimal haemodynamic abnormalities had normal or increased levels (except C4 at 62% of normal) and in eleven cases both tests for C.I.C. were simultaneously positive. Seventeen patients with severe septic shock had a decrease in IgG, IgM C1q, C3 and C4 and none had both tests for C.I.C. simultaneously positive (P less than 10(-4)). The disappearence of C.I.C. in patients with severe septic shock associated with evidence of complement activation suggests their involvement in the pathogenesis of septic shock in man.
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PMID:Circulating immune complexes in patients with gram negative septic shock. 736 8

Ten critically ill newborn infants presenting with documented septicemia were treated with antibiotics and supportive measures that included assisted ventilation, large blood transfusions and other volume expanders, sodium bicarbonate, and vasoactive drugs. Upon failure of the above treatment to improve the infants' rapidly deteriorating condition and the development of sclerema, exchange transfusions with fresh whole blood were performed and repeated up to four times. Seven of the ten infants showed immediate improvement and ultimately survived. IgM and IgA rose consistently with exchange transfusions. We postulate that these infants improved following exchange transfusion as the result of the removal of endotoxins, improvement of perfusion and of tissue oxygenation, decrease of hemorrhagic complications, and enhancement of the humoral and cellular inflammatory response. The development of sclerema in septicemic newborn infants continues to be an ominous sign despite the use of antibiotics and supportive measures. Our data suggest that exchange transfusions decrease the mortality of this group of critically ill infants.
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PMID:Role of exchange transfusion in the treatment of severe septicemia. 743 74

In this report, we present a 5 months old male baby, who suffered from watery diarrhea since 4 days old. From then on, he had been admitted 3 times in 3 different hospitals but the symptoms still bothered him off and on. During the days of hospitalization, sepsis with positive blood culture of Klebsiella was noted. The patient expired at 5 months of age. The T cell count was 20% active T was 0. Delayed hypersensitivity skin tests including Candida (10 X), PHA (10 micrograms), PHA (1 microgram), SK/SD (50 units) were negative. The granulocyte function study showed normal. Immunoglobulin analysis revealed IgG: 1320 mg%, IgA: 120 mg%, IgM: 100 mg%. Agenesis of thymus, failure of lymphoid differentiation and abnormal lymphoid architecture with absence of germinal centers were noted at autopsy. Combined immunodeficiency with normal immunoglobulins (Nezelof syndrome) is a disease of primary immunodeficiency characterized by recurrent infections, failure to thrive, lymphopenia, diminished lymphoid tissue, abnormal structure or agenesis of the thymus, and presence of normal or increased levels of one or more of the major immunoglobulin classes, but with impaired antibody synthesis. Since its original description by Nezelof and associates in 1964, it has been reported on the subsequent occasion. In this report, we present our one experience and review the clinical and laboratory data in 33 reported cases.
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PMID:Report of a case of Nezelof syndrome. 744 23


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