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

Thirty-eight patients who had sustained acute trauma, profound hemorrhagic shock, and massive transfusion were studied prospectively to determine the predominant etiologic factors in the development of post-traumatic jaundice. An analysis of clinical and biochemical factors occurring in association with each bilirubin peak in the postoperative course found the jaundice related to transfusion and surgery in 11 instances, to sepsis and septicemia in 15 instances, and to hepatic dysfunction in 23 instances. Results indicated that admission estimates of SGOT and LDH levels, the height of the bilirubin peak and the postoperative day on which it occurs, and the white cell count and GGT at the time of the peak may be of use in the differential diagnosis. Four case reports were used to emphasize the fluctuating pattern of jaundice and the different etiologic factors that may predominate. Light and electron microscopy from three patients illustrated the structural alterations that accompany the biochemical impairment of liver function and enable a more precise appreciation of this syndrome. Hepatic dysfunction appears to be implicated in a high proportion of patients who develop post-traumatic jaundice, which frequently occurs as part of a spectrum of multiple organ failure.
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PMID:Post-traumatic hepatic dysfunction as a major etiology in post-traumatic jaundice. 0 49

During acute lymphoblastic leukemia in children, bacterial infections occur during initial treatment, whereas virus infections are observed during remission. Mycoses and pneumocystis carinii infections are the commonest late complications. During agranulocytosis, any prolonged fever should be considered as due to infection and probably septicemia. The bacteria are usually of digestive origin. Antibiotic therapy is only very inconstantly efficacious, and the course follows closely the number of granular cells, thus justifying the use of white cell transfusions.
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PMID:[Infectious complications observed during the use of antimitotic agents in hematology]. 18 5

Infections, as a complication of umbilical artery catheterization, were studied in 65 sick newborn infants. Every second day during the catheterization period peripheral blood cultures as well as blood samples for white cell count and platelets were taken. Cultures were taken from the catheter tips and from the umbilicus at the time of withdrawal of the catheter. Local or systemic antibiotics were not used prophylactically, but on rather broad clinical indications. No case of septicemia was found, but 8 infants had positive blood cultures and 16 had positive catheter tip cultures. Positive catheter tip culture occurred more often in infants who were born before 32 weeks of gestational age. Neither the duration of the catheterization nor the treatment with antibiotics influenced significantly the frequency of positive cultures.
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PMID:Umbilical artery catheterization in newborns. II. Infections in relation to catheterization. 39 63

Thirty-six febrile neutropenic episodes were treated by granulocyte transfusions in 33 children. Septicemia and mucous membrane ulcerations were most commonly associated with the fever. Infection cleared in 81% of the episodes, eight per cent ended in death from bacterial infections, 11% from nonbacterial infections or hemorrhage. The median number of polymorphonuclear leukocytes given was 1.1 X 10(10)/m2/transfusion. Two to twenty-eight (median 8.5) transfusions were given over 3--34 days (median 10.5). The source of cells (parental or random) and the method of collection did not seem to affect the outcome. None of the 23 patients whose marrow recovered during the transfusions died of bacterial infections. Infection cleared even without marrow recovery in 62% of the patients, but then only 25% lived for more than two months after clearing of sepsis. In a subgroup of patients with nonlymphoblastic leukemia on the same chemotherapy and antibiotic treatment protocol, 8/11 (73%) survived bacteremia when white cell support was available; only 2/11 (18%) of a historical control group survived when such support was not available. Granulocyte support appears to be a valuable tool in helping neutropenic patients overcome their infections or, at the very least, helping them survive long enough for normal marrow recovery to occur.
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PMID:Granulocyte transfusions in infected neutropenic children with malignancies. 44 Feb 6

The purpose of this study was to assess the usefulness of the white cell ratio of immature neutrophils (PMNs) to total (immature plus mature) PMNs as an indication of infection in the very small premature infant. We retrospectively reviewed the charts of 59 premature infants less than or equal to 1,250 g admitted to our Newborn Intensive Care Unit over a one-year period who had at least one white count determined. Twenty-three were born after rupture of membranes for greater than or equal to 24 hours (PROM), 47 had a one-minute Apgar score less than or equal to 6 and 31 had a five-minute Apgar scores less than or equal to 6, 38 had respiratory distress syndrome (RDS), and 4 had confirmed infection. Thirty-one of the infants had a ratio greater than or equal to .15 in the first day of life, a value which has been suggested in the literature as being abnormal and an indication to suspect sepsis. This ratio bore no statistical relationship to PROM, low Apgar scores, or RDS. We analyzed these same relationships using a ratio greater than or equal to .25, another ratio derived from data in the literature which has been said to suggest infection. No statistical correlation was found for low Apgars or RDS, but there was a significant relationship between PROM and attainment of a ratio greater than or equal to .25 (p less than .005). It is notable that 2 out of the 4 infants with infection had a ratio less than .15. We wish to cast doubt on the applicability of the currently defined WBC ratios in the literature as they apply to the infant with birth weight less than 1,250 g and emphasize the apparent effect of PROM as a factor upon these ratios.
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PMID:The white cell ratio in the very low birth weight infant. 45 79

Four cases are described in which the patients suffered from bacteriaemia due to infected intravenous infusions. Although all the patients were pyrexial, the white cell count was normal in all 4 cases at diagnosis and the infusion site appeared innocent. Following removal of the intravenous catheter and the institution of antibiotic therapy in each case, neutrophilia and localizing signs developed. It is stressed that a normal white cell count and an innocent appearance at the infusion site do not exclude this complication of intravenous therapy. Possible reasons for this presentation for sepsis are discussed.
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PMID:Recognition of infection associated with intravenous catheters. 80 18

Forty-four patients with relapsed or resistant Hodgkin's disease were treated with adriamycin 40 mg m-2 i.v. on day 1, vincristine 1.4 mg m-2 i.v. on days 1 and 8, prednisolone 40 mg m-2 orally daily for 8 days, etoposide 200 mg m-2 orally daily for 4 days according to the nadir white cell count, and bleomycin 10 mg m-2 i.v. days 1 and 8 (HOPE-Bleo). Median age was 27 (range 12-71). When stage was considered according to all sites currently or previously involved by Hodgkin's disease (cumulative stage) 26 patients (59%) had stage IV, 13 (29%) stage III and five (11%) stage II disease; 33 (75%) had B symptoms. All patients had received previous chemotherapy and 18 (41%) had received two or more regimens. Twenty-six patients (59%) achieved CR and 10 (23%) PR; the median duration of CR was 22 months and median survival for all patients was 48 months. Eight patients remain in continuous CR; none of these had received extensive previous chemotherapy. Among the 19 patients who had relapsed from CR achieved by a single previous chemotherapy regimen, six (32%) achieved long CR on HOPE-Bleo. The regimen was generally well tolerated but the principal toxicity was myelosuppression. There were two toxic deaths, one due to neutropenic sepsis and the other due to acute peritonitis. The HOPE-Bleo regimen is an effective treatment for relapsed or resistant Hodgkin's disease, with a low probability of carcinogenesis and infertility. These factors suggest that HOPE-Bleo deserves further evaluation as primary treatment for Hodgkin's disease and very careful selection of relapsed patients for high dose salvage chemotherapy with bone marrow transplants must be exercised.
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PMID:Etoposide and adriamycin containing combination chemotherapy (HOPE-Bleo) for relapsed Hodgkin's disease. 169 23

This study was carried out retrospectively to evaluate the pattern of diseases associated with fever among infants aged 1-6 months at Gunung Wenang General Hospital Manado. During the period of January 1988-December 1989, 189 infants with age ranging 1-6 months, were evaluated. Diseases associated with fever predominantly occurred in infants of 3 months old (73.0%). The final clinical diagnosis of diseases associated with fever were gastroenteritis (39.15%), pneumonia (28.05%), meningitis (9%), respiratory tract infection (15.4%), post vaccination (4.20%) and septicemia (4.3%). The fever ranged from 37.8-38.3 degrees C (38%), 38.4-39.5 degrees C (49%), 39.6-41 degrees C (10%) and more than 41 degrees C (3%). The elevated body temperature was significantly related to the duration of fever (p 0.01). Increased erythrocyte sedimentation rate and thrombocytopenia were not correlated significantly (p greater than 0.05) with elevated body temperature while the total white cell count had a significant relationship (p less than 0.05).
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PMID:Pattern of diseases associated with fever among infants aged 1-6 months. 179 90

A wide range of imaging tools is available for the investigation of abdominal sepsis. Plain films and barium studies alone are generally regarded as inadequate and most patients will require ultrasound, CT or nuclear medicine studies to locate the source of sepsis. The choice of imaging modality depends on several factors, most important of which are the clinical condition of the patient and the presence or absence of localizing signs and symptoms. Ultrasound has the advantage of being portable and is therefore probably the best initial imaging method for the critically ill patient. It should also be the first investigation in patients with signs and symptoms localizing to the right upper quadrant, renal areas, subphrenic spaces or pelvis. Transvaginal ultrasound is particularly useful in examining the pelvis. CT is the imaging modality of choice for the pancreas and retroperitoneum and in patients who are poor candidates for ultrasound or in whom visualization on ultrasound is inadequate. In patients with PUO or evidence of sepsis without localizing signs or symptoms, nuclear medicine studies in the form of 67Ga citrate or labelled white cell scans are useful to localize the septic focus, although in most cases CT or ultrasound will subsequently be required for detailed anatomical definition. Imaging techniques have an increasingly important role to play in the treatment of sepsis, and guided aspiration and drainage may be performed with a high degree of accuracy under ultrasound or CT guidance, eliminating the need for surgical intervention in many individuals.
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PMID:Intra-abdominal sepsis: the role of radiology. 193 31

After a follow up of 22 months we report results of treatment on 44 patients (22 males), aged 16 to 63 years, with acute non lymphoblastic leukemia. Complete remission was obtained in 22 patients. This was significantly more frequent in patients under 40 years of age with white cell counts under 35,000 and without metabolic complications nor disseminated intravascular coagulation before treatment. Delaying chemotherapy for 5 days after diagnosis was also associated to a better prognosis. Overall actuarial survival rate was 37% at 15 months, 55% for those experiencing a first remission. A total of 25 patients [corrected] have died, 15 during induction of therapy, 7 after complete remission and 3 after failure of induction. Infections are the main cause of death during induction, with a high lethality for sepsis (33%) and pneumonia (40%).
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PMID:[Treatment of acute non-lymphoblastic leukemia in adults. Preliminary report from the national protocol on antineoplastic drugs]. 213 62


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