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

73 cases of anthrax were recorded by the Health Office in the Sivas region in the last 4 years. This paper presents a rare and severe clinical form of anthrax displaying diagnostic difficulties. Six women aged between 16-46 were diagnosed as having throat anthrax and treated in the Infectious Diseases Department of Cumhuriyet University. The lesions were localized on the tonsils in 5 cases and on the base of the tongue in 1 case. The main clinical features were sore throat, dysphagia, fever, regional lymphadenopathy on the neck and toxemia. Three patients died with toxemia and sepsis. The diagnosis was confirmed by the isolation of Bacillus anthracis.
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PMID:Primary throat anthrax. A report of six cases. 377 69

Of 35 cases diagnosed as anthrax during 1.9.1981 - 1.12.1982, 18 were females (51,4%) and 17 were males (48,6%), the mean age was 39,7. All of the women were housewives, 14 male patients were farmers, 1 was a tradesman, 1 a worker, and 1 a butcher. It was localised on the skin in 31 cases (88,6%) and in the throat in 4 cases (11,4%). Penicillin was used for treatment. In one of the cases with throat localisation, sepsis developed, leading to death.
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PMID:[A review of 35 anthrax cases]. 688 96

Hemorrhagic lymphadenitis of the intrathoracic lymph nodes and mediastinitis are shown to be the primary septical focus, this indicating an inhalation route of the contamination with development of pulmonary anthrax. The alterations in the gastrointestinal tract and central nervous system are considered to be secondary resulting from lymphohematogenic generalization of the anthraxic sepsis. The attention is drawn to the morphological signs of the immunodepression and the inhibition of granulocytic reaction. It is noted that the epidemic outburst of the pulmonary anthrax is without analogs and its development may be the result only of a massive penetration of bacteria into the atmosphere.
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PMID:[Pathology of anthrax sepsis according to materials of the infectious outbreak in 1979 in Sverdlovsk (various aspects of morpho-, patho- and thanatogenesis)]. 798 34

There are three clinical presentations of anthrax in humans: cutaneous (>95% of cases), orogastric and inhalational. The infectious form, the spore, enters the body and is thought to germinate within macrophages either at the site of inoculation (cutaneous or orogastric) or in the regional lymph node (inhalational). The bacillus then synthesizes its antiphagocytic capsule and the lethal and oedema toxins which interfere with the non-specific host defences leading to the characteristic locally destructive lesion and spread by lymphatics to the systemic circulation and other organs. The cutaneous form begins as a papule which progresses over several days to a vesicle and then ulcerates. There is often oedema, sometimes massive, probably due to the oedema toxin that surrounds the lesions which then develop a characteristic black eschar. The patient may be febrile with mild to severe systemic symptoms of malaise, headache and toxicity. Oropharyngeal anthrax presents with severe sore throat or an ulcer in the oropharyngeal cavity associated with neck swelling, fever, toxicity and dysphagia. Gastrointestinal anthrax begins with anorexia, nausea, vomiting and abdominal pain which may be similar to an acute abdomen. There may be diarrhoea and ascites, both of which may be haemorrhagic. Inhalational anthrax begins with non-specific symptoms of malaise, fever, myalgia and non-productive cough. After a period of 2-3 days, this is followed by a sudden onset of severe respiratory distress associated with diaphoresis, cyanosis and increased chest pain. There may be a widened mediastinum and pleural effusions on chest X-ray. Death follows in 24-36 h from respiratory failure, sepsis and shock. The diagnosis of anthrax is easy if it is considered. The organism is readily observed by Gram or Wright stain in local lesions or blood smear and can be easily cultured from the blood and other body fluids. However, because of its rarity, it is not often included in the differential diagnosis and in inhalational disease the diagnosis is rarely made until the patient is moribund. More rapid diagnostic tests are under development. Penicillin, combined with supportive care, remains the mainstay of treatment, although the organism is susceptible in vitro to many antibiotics. In recent years, there have been significant advances in our knowledge of the organism and its toxins and it is anticipated that similar progress will be made in the future in developing more rapid diagnostic tests and new modalities of treatment.
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PMID:Clinical aspects, diagnosis and treatment of anthrax 1047 74

The authors explain the anthrax pathogeny as necessary base to treat the systemic anthrax, that it can be secondary to a terrorist aggression, that until now it causes death to damaged people. For fear that a contamination with anthracis spores by a terrorist aggression, it is imposed to administrate chymeprotection to damaged people, because once it is appeared the symptoms of the systemic illness, the antibiotics don't stop the process evolution. For that reason, we think it is important to know the process pathogeny, where it can be found the keys for effective treatment of carbuncle sepsis.
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PMID:[Carbuncle (anthrax) as biological weapon]. 1205 61

Anthrax is essentially a disease of grazing herbivorous animals. The most common form of the disease is cutaneous anthrax, which accounts for 95% of all cases. We report here 39 cutaneous anthrax cases in humans that were seen in Eastern Anatolia over a six-year period. The clinical presentation was malignant edema in 16 of the cases (41%) and malignant pustule in 23 (59%). A secondary bacterial infection was present in 13 patients (33.3%) in the vicinity of the lesions. The agent was observed using Gram-stained smears in 25 patients (64%), and Bacillus anthracis was isolated from 15 patients (38.5%). All of the patients were treated with penicillin G or penicillin procaine, except one patient who had a penicillin allergy. One patient with cervical edema (2.5%) died as a result of laryngeal edema and sepsis syndrome. In conclusion, we found that the appearance of the skin lesion of cutaneous anthrax may vary, and this fact, combined with the rarity of this disease, which contributes to a general lack of experience among medical personnel, may make diagnosis difficult in nonagricultural settings
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PMID:Cutaneous manifestations of anthrax in Eastern Anatolia: a review of 39 cases. 1467 1

Systemic anthrax infections can be characterized as proceeding in stages, beginning with an early intracellular establishment stage within phagocytes that is followed by extracelluar stages involving massive bacteraemia, sepsis and death. Because most bacteria require iron, and the host limits iron availability through homeostatic mechanisms, we hypothesized that B. anthracis requires a high-affinity mechanism of iron acquisition during its growth stages. Two putative types of siderophore synthesis operons, named Bacillus anthracis catechol, bac (anthrabactin), and anthrax siderophore biosynthesis, asb (anthrachelin), were identified. Directed gene deletions in both anthrabactin and anthrachelin pathways were generated in a B. anthracis (Sterne) 34F2 background resulting in mutations in asbA and bacCEBF. A decrease in siderophore production was observed during iron-depleted growth in both the DeltaasbA and DeltabacCEBF strains, but only the DeltaasbA strain was attenuated for growth under these conditions. In addition, the DeltaasbA strain was severely attenuated both for growth in macrophages (MPhi) and for virulence in mice. In contrast, the DeltabacCEBF strain did not differ phenotypically from the parental strain. These findings support a requirement for anthrachelin but not anthrabactin in iron assimilation during the intracellular stage of anthrax.
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PMID:Bacillus anthracis requires siderophore biosynthesis for growth in macrophages and mouse virulence. 1475 82

On September 11, 2001, the Connecticut Department of Public Health (CDPH) initiated daily, statewide syndromic surveillance based on unscheduled hospital admissions (HASS). The system's objectives were to monitor for outbreaks caused by Category A biologic agents and evaluate limits in space and time of identified outbreaks. Thirty-two acute-care hospitals were required to report their previous day's unscheduled admissions for 11 syndromes (pneumonia, hemoptysis, respiratory distress, acute neurologic illness, nontraumatic paralysis, sepsis and nontraumatic shock, fever with rash, fever of unknown cause, acute gastrointestinal illness, and possible cutaneous anthrax, and suspected illness clusters). Admissions for pneumonia, gastrointestinal illness, and sepsis were reported most frequently; admissions for fever with rash, possible cutaneous anthrax, and hemoptysis were rare. A method for determining the difference between random and systemic variation was used to identify differences of >/=3 standard deviations for each syndrome from a 6-month moving average. HASS was adapted to meet changing surveillance needs (e.g., surveillance for anthrax, smallpox, and severe acute respiratory syndrome). HASS was sensitive enough to reflect annual increases in hospital-admission rates for pneumonia during the influenza season and to confirm an outbreak of gastrointestinal illness. Follow-up of HASS neurologic-admissions reports has led to diagnosis of West Nile virus encephalitis cases. Report validation, syndrome-criteria standardization among hospitals, and expanded use of outbreak-detection algorithms will enhance the system's usefulness.
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PMID:Hospital admissions syndromic surveillance--Connecticut, September 200-November 2003. 1571 28

Anthrax, like tuberculosis, shows a new epidemic spread in industrialized countries, revealing some ambiguous aspects to the disease and providing new challenges to medicine. Shiraz University of Medical Sciences has records of 7130 autopsies performed in the past 40 years, 33 of which are anthrax cases. We reviewed all the pathology slides of these cases and classified the organs involved in a search for unrecognized microscopic findings. The most common cause of death was sepsis, caused by organ involvement and direct cytotoxicity of Bacillus anthracis, in addition to its exotoxin production. Novel findings included hyaline membrane formation in respiratory system cases that is similar to acute (adult) respiratory distress syndrome and evidence of primary gastrointestinal involvement, showing the ability of the organism to pass the gastric barrier.
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PMID:Anthrax: pathological aspects in autopsy cases in Shiraz, Islamic Republic of Iran, 1960-2001. 1620 6

Studies that define natural responses to bacterial sepsis assumed new relevance after the lethal bioterrorist attacks with Bacillus anthracis (anthrax), a spore-forming, toxigenic gram-positive bacillus. Considerable effort has focused on identifying adjunctive therapeutics and vaccines to prevent future deaths, but translation of promising compounds into the clinical setting necessitates an animal model that recapitulates responses observed in humans. Here we describe a nonhuman primate (Papio c. cynocephalus) model of B. anthracis infection using infusion of toxigenic B. anthracis Sterne 34F2 bacteria (5 x 10(5) to 6.5 x 10(9) CFU/kg). Similar to that seen in human patients, we observed changes in vascular permeability, disseminated intravascular coagulation, and systemic inflammation. The lung was a primary target organ with serosanguinous pleural effusions, intra-alveolar edema, and hemorrhagic lesions. This animal model reveals that a fatal outcome is dominated by the host septic response, thereby providing important insights into approaches for treatment and prevention of anthrax in humans.
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PMID:Sepsis and pathophysiology of anthrax in a nonhuman primate model. 1687 46


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