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

The first, in our country, case of disseminated gonococcal infection is described, with a typical picture of present-day type of gonococcal sepsis, characterized by gonococcal bacteremia, polyarthritis, papulo -necrotic rash and febrile state, attenuated course and excellent effect by erythromycin treatment.
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PMID:[A case of gonococcal sepsis]. 361 13

The clinical and bacteriologic efficacy of ceftriaxone given once or twice daily was evaluated in 153 studies. A total of 2,635 patients received ceftriaxone given intramuscularly or intravenously, 930 received comparative antibiotics, and 81 received placebo. For the 10 major categories of infections treated (central nervous system, upper and lower respiratory tract, intraabdominal, skin and skin structure, bone and joint, urinary tract, gynecologic, and bacterial sepsis), the clinical response rates were 89 percent or greater. Bacteriologic cure rates were 84 percent or greater overall and 90 percent or greater for seven of 10 categories. Ceftriaxone achieved a satisfactory clinical response (cure or improvement) for 89 (intraabdominal) to 99 percent (urinary tract) of the infections treated. Additionally, pediatric central nervous system infections responded to twice-daily ceftriaxone injection; ceftriaxone, in a single dose as low as 250 mg, cured gonorrhea, and a single dose of ceftriaxone was as effective as multiple doses of cefazolin in surgical prophylaxis.
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PMID:Clinical and bacteriologic efficacy of ceftriaxone in the United States. 609 28

An acutely swollen joint may be indicative of a number of disease entities. A thorough history and physical examination are the cornerstones of evaluation. Laboratory findings can be useful in diagnosis, as can response to therapy (eg, response to penicillin in gonococcal arthritis is often the only criterion for diagnosis, as the organism is difficult to culture). Patients with malignancy (especially leukemia) or who are immunosuppressed or otherwise debilitated are at particular risk for a septic cause of swelling. Infectious arthritis should be the first potential cause looked for in these patients as well as in patients with such preexisting joint diseases as rheumatoid arthritis. The diagnosis of joint sepsis is confirmed by examination of aspirated joint fluid. In no case should a swollen joint be injected with corticosteroids until all possibility of infection has been eliminated.
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PMID:The acutely swollen joint. First impressions may mislead. 669 33

The chemistry, mode of action, antimicrobial activity, pharmacokinetics, and therapeutic efficacy of doxycycline are reviewed. Doxycycline displays excellent activity against gram-positive and gram-negative aerobic and anaerobic pathogens. The oral absorption of doxycycline is rapid and virtually complete and is not significantly decreased by food. Moreover, serum concentrations of doxycycline following oral and intravenous (i.v.) administration are comparable. Because of the prolonged half-life of doxycycline, once daily administration is possible. Tissue penetration of doxycycline is excellent. Levels within the therapeutic range have been found in most organs and tissues, including kidney, lung, gallbladder, prostate, intestinal tract, myocardium, sinus secretions, tonsil, aqueous humor, and female reproductive tissue. Doxycycline does not accumulate in patients with renal insufficiency and is not removed from the blood to any great extent during hemodialysis. Extensive clinical investigation has shown doxycycline to be highly effective in infections of the respiratory tract, including atypical pneumonias; skin and soft tissue; genitourinary infection including gonorrhea, syphilis, nonspecific urethritis, and prostatitis; intraabdominal infection due to trauma, sepsis, or surgery; and cholera. Evidence also suggests that doxycycline will prove effective in the treatment of Legionnaires' disease. In addition, placebo-controlled clinical trials suggest doxycycline is effective in the prevention of traveler's diarrhea.
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PMID:Doxycycline. 704 45

Benign gonococcal sepsis or disseminated gonococcal infection is a well defined clinical entity. Although the coincidence of several sexually transmitted diseases in the same patient has recently gained interest no case has been reported so far in which benign gonococcal sepsis was combined with further bacterial infections of the genitals. Therefore the case of a 25-year-old woman is reported who suffered from cervicitis, arthritis, and dermatitis due to neisseria gonorrhoeae infection and also harboured chlamydia trachomatis and ureaplasma urealyticum in her cervix. Facing this coincidence certain therapeutical and epidemiological conclusions must be drawn.
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PMID:[Triple bacterial infection of the cervix uteri in benign gonococcal sepsis]. 708 56

In 1964 Sweet described a new syndrome, characterized by the association of fever, neutrophilic leukocytosis, erythematous plaque affecting the extremities, neck and face, with histologically verified polymorphonuclear perivascular dermal infiltrates and a rapid response to corticosteroids. Although some 100 cases have since then been described the pathogenesis remains obscure. We present two cases which showed all criteria for Sweet's syndrome, in which the initial presentation of acute onset with fever, multiple skin lesions and especially the poor general state on one, made use at first think of an infectious process such as staphylococcal or gonococcal sepsis, in which case diagnosis must be differential. Only when the causal agent is known and an early skin biopsy is done can correct diagnosis and treatment be established.
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PMID:[Sweet's syndrome: report of two cases (author's transl)]. 732 31

A characteristic intermittent neutrophilic dermatosis, associated with polyarthritis, tenosynovitis, malaise, fever, and cryoglobulinemia, occurs in 20% of patients who undergo ileojejunal bypass surgery for the treatment of morbid obesity. The clinical syndrome may mimic gonococcal sepsis. The histologic changes in the skin are those of Sweet's syndrome. The syndrome remits spontaneously in most cases, but it may recur intermittently over a period of years. Treatment with low-dose steroids, tetracycline, or metronidazole suppresses symptoms in most cases, and restoration of normal bowel anatomy is curative. Skin testing with Streptococcus pyogenes antigen causes an excerbation of symptoms, or may provoke the entire syndrome de novo. Bacterial peptidoglycans, especially those of group A streptococci, produce similar arthritis and skin lesions in animal models. Peptidoglycans from numerous intestinal bacteria share common structural and antigenic features with S. pyrogenes peptidoglycan and are suggested as causative of the toxic and immunologic features of this syndrome.
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PMID:The bowel bypass syndrome: a response to bacterial peptidoglycans. 740 Apr 4

In Sandaun Province in Papua New Guinea, health professionals at the health center serving the people of Aitape District (Raihu Health Centre) compared data on deliveries before arrival (DBA) at the regional hospital in Wewak with data on 635 deliveries at Raihu Health Centre (HC) to examine differences in pregnancy complications and outcomes between the DBA and HC groups. All the deliveries occurred between 1990 and mid-1992. HC delivery cases were more likely to have had prenatal care than DBA delivery cases (90% vs. 52%). Multiple births were high (4% for DBA and 3.5% for HC), as was expected in Aitape District, where multiple births are common. The multiple births accounted for a high breech delivery rate (3.5-5.4%). Proper supervision during delivery would have likely reduced the high rate of retained placentas in the DBA group (21% vs. 1.3%). Other pregnancy complications more common in the DBA group than the HC group included postpartum hemorrhage (16% vs. 4.3%), need for blood transfusion (15% vs. 2.5%), and puerperal sepsis (18% vs. 4.3%). The DBA group also had a lower hemoglobin level and a higher gonorrhea rate and stayed in the hospital longer than the HC group (7.78 vs. 8.77 g/dl, 17% vs. 8%, and 6.54 vs. 5.4 days, respectively). Infants in the DBA group were more likely than those in the HC group to die in utero (10.5% vs. 2.3%) and die during the first week postpartum (4% vs. 2.5%), develop neonatal sepsis (17.2% vs. 8.4%), and weigh less (2.68 vs. 2.81 kg). These findings suggest that mothers who receive prenatal care and deliver at a health center experience fewer complications and have bigger and healthier newborns than mothers who deliver at home.
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PMID:A comparison between health centre deliveries and deliveries born before arrival in the Aitape district. 766 55

The penicillins are a large group of bicyclic ring compounds which contain a 4-membered beta-lactam ring (penams) fused to a 5-membered thiazolidine ring. Benzylpenicillin (penicillin G) was the first natural penicillin with potent activity against all Gram-positive pathogens, Gram-negative cocci and some spirochaetes and actinomycetes. For the last 50 years benzylpenicillin has been the mainstay of therapy for serious pneumococcal, streptococcal, meningococcal and gonococcal infections. However, the past decade has seen the emergence of resistance in certain parts of the world, initially among the gonococci, and more recently among the pneumococci and meningococci. Discovery of the 6-aminopenicillinamic acid nucleus has led to considerable manipulation of the basic ring structure, resulting initially in the synthesis of ampicillin, and subsequently the other aminopenicillins, analogues, esters and prodrugs. These drugs have the advantages of improved oral bioavailability and superior activity against Haemophilus influenzae, certain Gram-negative bacilli, salmonellae, enterococci and Listeria monocytogenes, making these agents popular in the treatment of upper and lower respiratory tract infections and urinary tract infections. The increasing spread of bacterial resistance, particularly among Enterobacteriaceae and H. influenzae, has curtailed the usefulness of these drugs in these clinical settings. To counteract this problem, a number of agents combining a penicillin and a beta-lactamase inhibitor (e.g. clavulanic acid, tazobactam and sulbactam) have been developed. These inhibitors have no intrinsic antibacterial activity, but combining them with a penicillin (e.g. amoxicillin/clavulanic acid) confers greater stability to beta-lactamases and hence a broader spectrum of activity. The emergence of penicillinase-producing staphylococci that rendered benzylpenicillin ineffective also stimulated the search for penicillinase-resistant penicillins--methicillin and nafcillin, followed by the acid-stable isoxazolyl penicillins. These agents are now the principle antistaphylococcal treatment. Methicillin-resistant coagulase-negative staphylococci are currently a major cause of hospital sepsis, and are resistant to these latter agents. Enteric Gram-negative bacilli have been the predominant cause of serious hospital infections during the last 30 years. Further manipulation of the penicillin structure has resulted in compounds with broader activity against Gram-negative bacilli, particularly Pseudomonas aeruginosa, while retaining activity against Gram-positive pathogens. The carboxypenicillins were the first step in this direction, but have been largely superseded by the ureidopenicillins. These agents have better activity against P. aeruginosa, and are still effective against Gram-negative and Gram-positive bacteria, including enterococci and anaerobic organisms.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Penicillins. A current review of their clinical pharmacology and therapeutic use. 769 96

By culturing for N gonorrhoeae in cases of neonates and children with conjunctivitis, vaginitis, urethritis, proctitis, sepsis, and arthritis, gonococcal infections can be identified easily. They are then treated with ceftriaxone. In neonates, the mother and her sexual contacts also should be treated. In children, a full evaluation for sexual contacts, with the assistance of other professionals, if necessary, will almost always identify a sexual contact. Appropriate action then can be taken to protect the child from further sexual contact. .
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PMID:Neisseria gonorrhoeae in children. 797 Aug 97


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