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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bacterial hepatic abscesses are a rare but serious disease. They develop either secondary to injuries or ischemia of the liver, infections in the drainage area of the portal vein, systemic sepsis or biliary infections. An abscess secondary to injuries or ischemia of the liver or infections in the drainage area of the portal vein, is usually caused by a mixed flora consisting of gramnegative aerobes and anaerobic bacteria. Hepatic abscesses secondary to systemic sepsis contain Staphylococci or Streptococci, while in abscesses on the basis of biliary infections gramnegative organisms are found. Clinically, one can find signs of systemic sepsis, pain in the right upper quadrant and a tender enlarged liver. Jaundice is absent unless a biliary obstruction is present simultaneously. The diagnosis is confirmed by ultrasonography or computerized tomography. An uncertain diagnosis can be confirmed by aspiration under ultrasonographic or computertomographic guidance. The therapy consists of administration of antibiotics and surgical or percutaneous drainage. Surgical drainage via laparotomy is always mandatory if one suspects a primary infectious focus within the abdomen. The mortality of multiple liver abscesses is 20 per cent, that of single abscesses 10 per cent. Amebic abscesses have been observed in nonendemic regions sporadically after travel or spontaneously. Clinical and radiological manifestations are the same as for bacterial abscesses. They are differentiated from bacterial abscesses by positive serology for amebiasis or aspiration which yields the typical anchovy paste. Most important complications are hepato-bronchial fistulae, empyema and amebic pericarditis. The therapy consists of a nitroimidazole and a luminal amebicide. Except for diagnostic reasons aspiration is only indicated for large abscesses of the left lobe of the liver. Mortality of an uncomplicated amebic liver abscess should be under one per cent.
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PMID:[Pathology, diagnosis and therapy of liver abscess]. 330 50

Metronidazole, a nitroimidazole derivative, is a unique antimicrobial agent that is active against both bacterial and parasitic organisms, although only the anaerobic members of these groups are susceptible. It has been used for the treatment of trichomoniasis for almost 30 years and is also effective in amebiasis and giardiasis. More recently, metronidazole has emerged as a principal agent for the treatment of anaerobic infections. It is highly effective against all species of anaerobes except certain non-spore-forming gram-positive bacilli and cocci and is the only agent rapidly bactericidal against the Bacteroides fragilis group. The hydroxy metabolite is 65% as effective as metronidazole and may play a major therapeutic role. Clinical studies have substantiated its efficacy for prophylaxis during elective colorectal surgical procedures and the treatment of deep abdominal sepsis (usually in combination with another agent such as an aminoglycoside). Metronidazole is the treatment of choice for bacterial vaginosis and seems to be as effective as vancomycin for treatment of Clostridium difficile-related diarrhea and colitis. Good blood levels are produced after both oral and intravenous administration, and side effects are infrequent and minimal. Metronidazole should not be taken during the first trimester of pregnancy because of concerns about mutagenicity. Tinidazole and ornidazole are recently developed nitroimidazole derivatives that have even greater antimicrobial activity than metronidazole.
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PMID:Symposium on antimicrobial agents. Metronidazole. 331 51

Retrospective pathology data from necropsies of 162 marmosets, Saguinus oedipus, were studied to determine the nature of chronic wasting syndrome, a poorly defined entity associated with a high mortality rate in many marmoset colonies. Paraffin sections of the gastroenteric organs of 116 of these marmosets were re-examined in detail; lesions were identified, quantitated, and analyzed with a method of multiple chi-square testing for possible associations between findings. Five distinct disease entities were identified: prosthenorchosis, amebiasis, paramyxovirus disease, sepsis, and chronic colitis. Lesions of several of these often occurred in the same monkey, and all but the first were associated with cachexia. Lesions of chronic colitis were crypt abscesses, mononuclear and polymorphonuclear infiltration of the lamina propria, epithelial cell atypia, karyorrhexis, and lymphoid hyperplasia. The cause of chronic colitis was not identified, nor was any explanation found for weight loss and increased susceptibility to disease.
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PMID:An analysis of the association of gastroenteric lesions with chronic wasting syndrome of marmosets. 615 4

Tinidazole is a 5-nitroimidazole with selective activity against anaerobic bacteria and protozoa. It is bactericidal at low concentrations and its spectrum covers most anaerobic bacteria and some capnophilic microorganisms. Anaerobic bacteria known to be resistant to tinidazole include anaerobic streptococci, actinomyces and propionibacteria. Tinidazole is one of the most active antibacterial agents against Bacteroides fragilis which is one of the most resistant species of anaerobic bacteria. Only a few strains have been reported to be resistant. Tinidazole has been shown to be efficacious in protozoal infections such as trichomonal vaginitis, amoebiasis and giardiasis. Clinical studies have also shown that tinidazole is efficacious in the treatment of anaerobic infections including respiratory tract infections, intra-abdominal sepsis and obstetrical and gynecological infections. Since tinidazole has no activity against aerobic bacteria, it must be combined with other antibacterial agents in the treatment of mixed infections involving aerobic and anaerobic bacteria. Tinidazole has also been used successfully alone or in combination with other antimicrobial agents for prophylaxis in patients undergoing elective colonic and abdominal surgery, emergency appendectomy and gynecological surgery.
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PMID:Tinidazole--microbiology, pharmacology and efficacy in anaerobic infections. 634 Dec 53

Metronidazole, a nitroimidazole derivative, is a unique antimicrobial agent that is active against both bacterial and parasitic organisms, although only the anaerobic members of these groups are susceptible. It has been used for the treatment of trichomoniasis for about 20 years and is also effective against amebiasis and giardiasis. More recently, metronidazole has emerged as a principal agent for the treatment of anaerobic bacterial infections. It is highly effective against all species of anaerobes except certain non-spore-forming gram-positive bacilli and cocci and is the only agent rapidly bactericidal against the Bacteroides fragilis group. Clinical studies have proved its efficacy in prophylaxis for elective colorectal surgical procedures and in the treatment of deep abdominal sepsis (usually in combination with another agent, such as an aminoglycoside). Metronidazole is the treatment of choice for nonspecific vaginitis that seems to be a mixed infection due to anaerobes and Gardnerella vaginalis. Adequate concentrations in the blood are produced after both oral and intravenous administration, and the side effects are infrequent and minimal.
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PMID:Metronidazole. 660 Aug 4

Retrospective pathology data from necropsies of 162 marmosets, Saguinus oedipus, were studied to determine the nature of chronic wasting syndrome, a poorly defined entity associated with a high mortality rate in many marmoset colonies. Paraffin sections of the gastroenteric organs of 116 of these marmosets were re-examined in detail; lesions were identified, quantitated, and analyzed with a method of multiple chi-square testing for possible associations between findings. Five distinct disease entities were identified: prosthenorchosis, amebiasis, paramyxovirus disease, sepsis, and chronic colitis. Lesions of several of these often occurred in the same monkey, and all but the first were associated with cachexia. Lesions of chronic colitis were crypt abscesses, mononuclear and polymorphonuclear infiltration of the lamina propria, epithelial cell atypia, karyorrhexis, and lymphoid hyperplasia. The cause of chronic colitis was not identified, nor was any explanation found for weight loss and increased susceptibility to disease.
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PMID:An analysis of the association of gastroenteric lesions with chronic wasting syndrome of marmosets. 681 72

Metronidazole is a 5-nitroimidazole that has selective activity against anaerobic microorganisms, including bacteria and protozoa. Intravenous metronidazole has recently been approved by the U.S. Food and Drug Administration for the treatment of serious anaerobic bacterial infections. It is usually bactericidal at low concentrations, and its spectrum of activity encompasses almost all anaerobic bacteria and some capnophilic organisms. Anaerobic bacteria known to be resistant to metronidazole include occasional anaerobic cocci, some nonsporulating gram-positive bacilli and propionibacterium. Metronidazole is the most active antimicrobial agent against Bacteroides fragilis, the most resistant of anaerobic bacteria. Kill-curve studies demonstrate that there is a 2 to 5 log decrease in the number of colony forming units of B. fragilis and Clostridium perfringens within one hour. The only well documented metronidazole-resistant strain is a B. fragilis isolated from the normal flora of a patient on long-term metronidazole therapy for Crohn's Disease. Metronidazole resistance in Trichomonas vaginalis has recently been described in a few strains that are able to survive at increased oxygen tensions. Metronidazole has been shown to be efficacious in certain protozoal infections including trichomonal vaginitis, extraintestinal amebiasis, and giardiasis. Clinical studies have shown metronidazole to be efficacious in the therapy of a variety of anaerobic infections, including non-traumatic brain abscesses, intraabdominal sepsis, pelvic suppuration and necrotizing soft tissue infections. There have been disappointing results in the therapy of anaerobic pleuropulmonary infections with a number of superinfections caused by aerobic bacteria. Since metronidazole lacks any activity against aerobic bacteria, it must be combined with other agents, usually aminoglycosides, in the treatment of mixed infections involving anaerobic and aerobic bacteria.
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PMID:Metronidazole: in vitro activity, pharmacology and efficacy in anaerobic bacterial infections. 692 1

Fulminating colitis rarely develops as a complication of amebiasis; however, it is difficult to diagnose and treat, and associated with a very high mortality rate. We report herein the case of a 62-year-old man with superacute fulminant necrotizing amebic colitis who, despite treatment with aggressive surgery and antiamebic agents, died of multiple organ failure following sepsis on the 25th day after onset. The patient had no immmunosuppressive disorders and claimed that he had never had homosexual intercourse, or traveled to the tropics in recent years. Since the incidence of amebiasis is increasing in developed countries, including Japan, more attention should be focused on the fulminating nature of this disease.
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PMID:Acute fulminant necrotizing colitis caused by amebiasis: report of a case. 1218 29

Leukocyte adhesion deficiency (LAD) is a rare disorder of cellular immunity, generally due to various mutations producing reduced or altered expression of membrane integrins. The authors report a case of LAD due to integrins expression imbalance. LAD was suspected after recurrent sepsis, fungal infection and amoebiasis with persistent leukocytosis. Neutrophils were studied with chemiluminescence showing decreased functional activity: up to now, this seems the first chemiluminescence study of neutrophil function and the first report of amoebiasis at the onset in LAD.
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PMID:Decreased chemiluminescence in leukocyte adhesion deficiency presenting with recurrent sepsis, amoebiasis and Candida albicans urinary tract infection. 1714 24

Here we present an interesting and extremely rare case of a 66 year old male who developed a colocutaneous fistula secondary to amoebiasis. The patient presented with an acute history of right lower abdominal pain, weight loss and a palpable mass. A CT scan demonstrated a fluid filled cavity in the right iliac fossa consistent with an appendiceal abscess which was drained under radiological guidance. However, following drainage his symptoms remained requiring open surgical drainage, and a controlled caecostomy was performed due to a small caecal perforation. Despite appropriate conservative therapy he failed to progress, and developed localised sepsis in the right iliac fossa with a colocutaneous fistula, requiring a formal right hemicolectomy. The histological examination confirmed the presence of abundant trophozoites of Entamoeba histolytica.We highlight the fact that in the modern age of immigration and long distance travel, it will become increasingly likely that the so-called 'tropical' diseases will present throughout the world. This case also highlights the need to keep an open mind in cases that do not progress as expected, and to react accordingly to any unusual developments.
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PMID:Colocutaneous fistula secondary to amoebiasis. 2209 84


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