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

Mycotic aneurysms of the aorta are uncommon in babies and children. Prior to the development of antibiotics, most mycotic aneurysms were seen secondary to bacterial endocarditis, but this is now uncommon. Instead, more cases have been reported as complications of umbilical artery catheters in newborns. We have seen five cases of mycotic aneurysms in children, two of them secondary to umbilical artery catheters. One patient had coarctation of the aorta, and the other patients had different sources of infection. Three patients were treated surgically by us with good results after antibiotic therapy. One patient died of sepsis before the aneurysm was diagnosed. The fifth patient was treated elsewhere and now has a recurrent aneurysm. We think a combination of aggressive medical and early surgical therapy may save a high percentage of these patients.
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PMID:Mycotic aortic aneurysms in children. 654 51

A case of bacterial endocarditis in a newborn without any congenital heart disease is reported. The clinical diagnosis was suspected on evolutive heart failure by mitral dysfunction with sepsis. T.M. mode echocardiography could detect only the valvular defects. Correlations between anatomic and echocardiographic findings allowed to discuss the limits of the method. Neonatal bacterial endocarditis is a rare event. Its diagnosis is difficult and its prognosis very poor. This affection must be prevented.
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PMID:[Infectious endocarditis in the neonatal period]. 667 24

Mycotic aneurysms are uncommon but not rare lesions with potential for catastrophic hemorrhage or sepsis. They have been ascribed to bacterial endocarditis and, when present in the aorta, were termed "inevitably fatal" as recently as 1967. A 15-year review of the English-language literature on mycotic aneurysms showed that arterial trauma, concurrent sepsis, and depressed host immunity have become the cardinal "risk factors" in the development of these lesions. Conventional treatment of mycotic aortic aneurysms usually includes aortic ligation, aneurysmal excision, and extra-anatomic bypass grafting. Nevertheless, four of our patients with well-localized mycotic aortic aneurysms survived three to 54 months (mean, 40 months) after aortic excision and in situ prosthetic graft restoration of aortic continuity. This experience suggests that mycotic aortic aneurysms can be successfully treated, frequently by in situ grafting, if diagnosis and treatment are timely and aggressive.
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PMID:Mycotic aortic aneurysms. A reappraisal. 668 77

The clinical spectrum of neonatal endocarditis, including bacterial and nonbacterial types, is examined in five case reports that were drawn from nursery experiences over a recent 2-year period. In contrast to previous reports of 100% mortality from neonatal endocarditis, one patient survived. Changing heart murmur and hematuria were most frequently associated with bacterial and nonbacterial endocarditis in four of the five cases. Pulmonary hypertension, thrombocytopenia, and coagulopathy were also associated with nonbacterial endocarditis. Echocardiograms were performed on four of the patients; only one was suggestive of endocarditis. Staphylococcus aureus was isolated from both cases of bacterial endocarditis, including the single survivor. Thus, it is suggested that the initial antibiotic coverage of any neonate with the clinical syndrome of sepsis, hematuria, and a heart murmur include antistaphylococcal coverage for the possibility of bacterial endocarditis.
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PMID:Endocarditis in high-risk neonates. 682 46

Candidosis was recognized retrospectively in the hearts of 20 of 8,975 patients (0.2%) who had complete postmortem examinations done in Central Kentucky and South Florida. This mycosis, characterized by myocardial micro-abscesses with yeasts and pseudohyphal elements in 18 patients, was the most common fungal cardiac infection. Noncaseating granulomas were seen in only one patient. Infective endocarditis due to Candida species was found in seven individuals and involved the mitral valve most frequently. The 20 infected persons varied in age from 20 days to 65 years, with a mean age of 37 years, and included 11 males and nine females. All had compromising, usually benign, underlying diseases complicated by antibiotic therapy for suspected or proven Gram-negative sepsis. Typically, these patients were extremely ill, and eight had recognized conduction disturbances including altered heart rates and rhythms. Deep candidosis was considered a major factor in every patient's death. Experimental deep candidosis in 12 infected, adult laboratory rats was characterized by similar haphazardly scattered myocardial microabscesses with fungal elements in eight (67%). Endocarditis in the rats was not seen in this intracardiac injection model. Widespread antibiotic exposure in patients who have compromising underlying diseases portends an increasing incidence of deep candidosis, which as the potential to infect any tissue, particularly the heart, and to create cardiac arrhythmias and death.
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PMID:The potentially lethal problem of cardiac candidosis. 698 62

During a period of 29 months positive hemocultures to Streptococcus agalactiae corresponding to eight adult patients have been observed. These bacteria were apparently responsible for the clinical picture in five patients. In other two patients S. agalactiae appeared in the course of a sepsis caused by other germ. The remaining patient had a transient bacteremia and no treatment was required. Septic shock and bacterial endocarditis were the cause of death in two patients. Six patients cured. Literature on this subject is reviewed and the better prognosis of sepsis due to S. agalactiae in adults than in neonates is stressed. Endocarditis and meningitis occur as severe complications with poor prognosis. In patients with endocarditis the administration of penicillin and gentamicin as well as the consideration of early surgical replacement of the affected heart valve is recommended. Intravenous penicillin and gentamicin associated with intrathecal gentamicin are indicated in meningeal infections. Vancomycin is a good substitutive antibiotic in patients with penicillin hypersensibility.
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PMID:[Bacteremia and sepsis due to Streptococcus agalactiae. Study of eight cases (author's transl)]. 699 50

Four patterns of tissue involvement can be distinguished in sepsis due to gram-negative enteric bacilli. When intense local inflammation predominates, cellulitis or thrombophlebitis results, often with venous or arterial obstruction. Bacteria are present in the affected tissues, but not in sufficient numbers to be seen microscopically. When bacterial proliferation is unchecked by an appropriate leukocyte response, ecthyma gangrenosum, erythema multiforme, or diffuse bullous lesions may occur with minimal clinical or histologic signs of inflammation. In symmetric peripheral gangrene associated with disseminated intravascular coagulation, bland fibrinous deposits are seen in small vessels but neither inflammatory cells nor bacteria are present. The fourth kind of lesion is that seen in bacterial endocarditis. In all four patterns a vascular component is prominent clinically and histologically. The pathogenesis of these lesions is multifactorial; in each individual case the interaction between bacterial and host factors probably determines which clinical picture will result. The appearance of symmetric soft tissue lesions of the extremities in the absence of predisposing local conditions suggests the possibility of sepsis due to gram-negative bacilli, especially if other clinical features indicate that sepsis might be present.
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PMID:Cutaneous and soft-tissue manifestations of sepsis due to gram-negative enteric bacilli. 701 88

When patients allergic to penicillin develop life-endangering infections that require treatment with beta-lactam antibiotics, they face a fatal infection or the possibility of a fatal allergic reaction. We have approached this situation by using an oral desensitization procedure before full-dose antibiotic therapy. Thirty consecutive patients with histories of allergic reactions to penicillin, positive immediate wheal and flare skin-test reactions to penicillin determinants, and life-threatening infections were studied. Bacterial endocarditis requiring penicillin G therapy led to desensitization of 19 patients, Pseudomonas sepsis of pneumonia requiring treatment led to desensitization of nine subjects, and staphylococcal infections requiring therapy with a penicillinase-resistant penicillin led to desensitization of two patients. Penicillin G or carbenicillin were administered orally, beginning with 100 U or 60 microgram, respectively. At 15-min intervals, progressively doubled doses were given during continuous monitoring for the appearance of allergic reactions. Within 5 hr, full therapeutic doses were administered intravenously. Skin-test reactions disappeared or diminished in all 23 subjects who were retested after desensitization. Full courses of antibiotic therapy and cure of the infections were accomplished in 30 of 30 patients. No deaths, anaphylaxis, or severe acute allergic reactions occurred. Pruritic cutaneous eruptions appeared in nine patients (30%) 6 to 48 hr after the onset of therapy. One patient developed reversible nephritis 3 wk into therapy with penicillin G. The results of this study suggest that oral desensitization is an effective, relatively safe approach to administering beta-lactam antibiotics to penicillin-allergic patients with life-threatening infections.
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PMID:Desensitization of patients allergic to penicillin using orally administered beta-lactam antibiotics. 706 69

An unconventional presentation of an elderly man with sepsis and a nonfunctioning permanent cardiac pacemaker is reviewed. Our interpretations of signs of an acute abdomen and laboratory evidence suggestive of acute cholecystitis did not lead to the correct diagnosis. The pacemaker electrode had perforated the myocardium and this event is believed to be secondary to bacterial endocarditis at the electrode tip. The therapeutic implications of this unique case are discussed.
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PMID:Sepsis and pacemaker malfunction. 712 76

Mycotic aneurysms of the extracranial carotid arteries are rare, with only 27 cases reported in the English literature. The causative organism is most frequently Staphylococcus but infections due to Streptococcus, Salmonella and Klebsiella have been reported. Escherichia coli has been reported as the causative organism in three cases. Mycotic aneurysms usually present in the setting of generalized sepsis such as postoperative infection, septicaemia, dental sepsis, drug addiction or bacterial endocarditis. We report a patient who presented with a mycotic aneurysm of the internal carotid artery 2 months after undergoing a laparotomy for perineal sepsis.
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PMID:Mycotic cervical carotid aneurysm. 766 13


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