Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although common in tropical regions, pyomyositis is rare in the continental United States. Fewer than 50 cases have been reported to date. It is characterized by suppuration of large muscle groups that can, if not quickly and appropriately treated, lead to sepsis and death. Diagnosis can be difficult secondary to the atypical appearance of the abscess process early on. Almost all cases have occurred in otherwise healthy people. The simultaneous occurrence of pyomyositis and immunodeficiency is rare. A recent report of a case in an adult with the acquired immunodeficiency syndrome (AIDS) is not, however, unexpected. We describe the first documented occurrence of pyomyositis in a child with AIDS. A brief review of the topic is included. Pyomyositis should be included in the list of unusual infections that can occur in children with AIDS.
 ...
PMID:Pyomyositis in a child with acquired immunodeficiency syndrome. Patient report and brief review. 274 46

Immune thrombocytopenia is a well-recognized part of the clinical spectrum of infection with the human immunodeficiency virus. From November 1985 to February 1988, 15 patients who were human immunodeficiency virus-positive underwent splenectomy for refractory immune thrombocytopenia. Eight patients had thrombocytopenia only, and 7 others were pancytopenic prior to splenectomy. Three of the 15 patients fulfilled criteria for acquired immunodeficiency syndrome before splenectomy, and acquired immunodeficiency syndrome developed in 5 patients during the follow-up period. The median duration of thrombocytopenia prior to surgical therapy was 6 months. A bone marrow biopsy specimen showed hypercellularity with increased megakaryocytes. All patients had a therapeutic response to splenectomy. Long-term remission from thrombocytopenia/pancytopenia was achieved in 14 of the 15 patients during a follow-up period of 2 to 21 months. Splenectomy can be accomplished with an acceptable morbidity. Pneumonia developed postoperatively in 2 patients, but they did not manifest the characteristic picture of overwhelming postsplenectomy sepsis. They had received vaccinations against encapsulated organisms preoperatively. We conclude that splenectomy provides a durable and lasting response for HIV-related thrombocytopenia. Vaccination for Streptococcus pneumonia and Haemophilus influenzae should be given prior to splenectomy although its efficacy is not clear in this group.
 ...
PMID:Splenectomy. The treatment of choice for human immunodeficiency virus-related immune thrombocytopenia? 278 77

The destruction of proliferating lymphoid cells within germinal centers with subsequent replacement by histiocytoid cells has been described in infants and children dying of viral and bacterial infections. The etiology and significance of "epithelioid germinal centers" (EGCs) are unknown. The cells implicated in forming EGCs have included histiocytes and dendritic reticulum cells. We have studied four children at autopsy who died at ages ranging from 10 months to 7 years. Three contracted fatal infections, one with fulminant meningococcemia, one with bacterial sepsis, and one with viral hepatitis. The fourth child contracted viral pneumonitis and died of acetaminophen toxicity. Epithelioid germinal centers were found in numerous lymphoid organs (spleen, lymph nodes, and Peyer's patches) in all four cases. Avidin-biotin complex immunohistochemical analysis performed on formalin-fixed splenic tissue from the first three cases and snap-frozen splenic tissue from the second case revealed an absence of B cells in the follicular centers. The mantle zones surrounding follicles were thin but intact. The histiocytoid cells expanding the germinal centers were positive for S100 and R4/23 (dendritic reticulum cells) and negative for numerous histiocyte markers (alpha 1-antitrypsin, alpha 1-antichymotrypsin, and lysozyme). Increased numbers of killer cells (Leu-7) were present within the affected germinal centers in the three cases in which material was available for immunohistochemical studies. Overwhelming infections in these patients seem to result in anomalous natural killer cell activation resulting in localized nonselective destruction of follicular centers similar to anomalous natural killer cell activity reported to occur in fatal infectious mononucleosis. This may lead to an acquired immunodeficiency that precludes long-term survival in affected patients.
 ...
PMID:Epithelioid germinal centers in overwhelming childhood infections. The aftermath of nonspecific destruction of follicular B cells by natural killer cells. 284 41

We studied 14 patients with neuromuscular disorders and concomitant infection with human immunodeficiency virus to define clinical syndromes and prognosis. Eight patients had painful sensorimotor peripheral neuropathy; two, chronic inflammatory demyelinating polyneuropathy; two, mononeuropathy or mononeuropathy multiplex; one, recurrent myoglobinuria; and one, chronic proximal weakness and elevated creatine kinase levels. All eight patients with painful neuropathy had overt symptoms of acquired immunodeficiency syndrome. Chronic inflammatory demyelinating polyneuropathy was the first manifestation of acquired immunodeficiency syndrome in both patients with this syndrome. Both died from overwhelming sepsis within six months of the neuropathy's onset. Patients with mononeuropathy multiplex had a variable course. Immunosuppressant medication had no effect in two patients.
 ...
PMID:The neuromuscular manifestations of human immunodeficiency virus infections. 284 98

Factors contributing to the high prevalence of immunodeficiency in the PICU population include conditions that lead to frequent requirement of intensive care, suppression of immunity secondary to an acute insult, and iatrogenic measures. The immunodeficiency observed in the critically ill correlates well with their susceptibility to infection and explains the high prevalence of nosocomial sepsis in the PICU--a major cause of morbidity and mortality in critically ill children. Dysactivation of the immune system during an acute insult, with the subsequent release of humoral mediators from activated immune cells, leads to tissue injury and may be involved in the pathogenesis of ARDS, DIC, capillary leak syndrome, and to the development of multiple organ system failure. Suggested approaches to correct the immunodeficiency in the critically ill include reconstitutional immunotherapy, mediator-inhibiting drugs, and mediator removal by plasma exchange. Intensivists should be aware of the phenomenon of immunodeficiency in the critically ill, be accordingly aggressive in diagnosing and treating infections, and avoid, as much as possible, measures that further suppress immunity.
 ...
PMID:Immune dysfunction in the critically ill infant and child. 305 6

Four patients with hemophilia A have undergone liver transplantation in our institution, three successfully. The first was a 21-year-old man with chronic active hepatitis (CAH) in whom the effects of previous abdominal operations prevented the satisfactory technical insertion of the new liver. He died intraoperatively. The second patient was a 15-year-old boy with CAH who began to synthesize factor VIII coagulant activity (F VIII:C) within 18 hours of successful liver transplantation and has continued to do so for almost 2 years (F VIII:C range 0.89 to 3.20 U/mL). The first 2 months of his postoperative course were complicated by infections, but since that time he has done well and has returned to school. The third patient was a 48-year-old man with portal fibrosis and severe ascites. He synthesized F VIII:C (range 0.96 to 1.50 U/mL) within six hours after reestablishment of circulation through the new liver. His postoperative course was complicated by numerous infections, and he died with sepsis and an acquired immunodeficiency-like syndrome 4 months after transplantation. The fourth patient was a 47-year-old mild hemophiliac with CAH who produced adequate factor VIII:C levels following transplantation (range 0.79 to 2.80 U/mL). These patients demonstrate that liver transplantation in hemophiliacs with end-stage liver disease may be lifesaving and results in correction of the F VIII:C deficiency and associated hemorrhagic tendency.
 ...
PMID:Liver transplantation in hemophilia A. 1947 Apr 40

In a study to investigate the incidence and significance of surgical glove perforation, bacterial contamination of surgeons' hands and gloves before and after operation was measured and the gloves tested for damage. Perforations were found in 74 of 582 gloves (12.7 per cent) and occurred in 34.5 per cent of operations. Glove perforation did not influence bacterial counts on the surgeons' hands or on the outside of their gloves. A separate clinical study of 100 adult hernia repairs gave no evidence that perforation increased wound sepsis. After standard pre-operative hand preparation, glove perforations are of no clinical significance to the patient, but their high incidence should alert surgeons to the need for protection against pathogens transmissible during surgery, such as hepatitis B and the human immunodeficiency virus. Protection of the surgeon is the main indication for preoperative change of damaged gloves.
 ...
PMID:Surgical glove perforation. 321 43

Available is a case of mycobacterial sepsis in patients with immunodeficiency of undetermined origin and presenting morphologically with disseminated Kaposi's sarcoma. The disease ran the course and exhibited morphological manifestations similar in some details to AIDS. The author advocates a differentiated approach to evaluation of clinical and pathological findings in cases close in appearance.
 ...
PMID:[Kaposi's sarcoma combined with generalized miliary tuberculosis]. 325 Mar 86

A clinicopathological investigation was made on 15 autopsy cases with allogeneic bone marrow transplantation. Engraftment was recognized in 11 patients, 6 out of which survived more than 100 days postgrafting, and 5 terminated within 100 days. The other patients succumbed to sepsis before engraftment. In 8 evaluated cases with clinical acute graft versus host disease (GVHD), involvement of acute GVHD was histologically confirmed in the skin, liver, and/or intestine. Atypical ductal changes similar to those of interlobular bile ducts were noted in the pancreas and esophageal gland in a patient with severe acute GVHD. Although 6 long-term patients showed neither definite lichenoid papulae nor sicca syndrome diagnostic for clinical chronic GVHD, 4 patients exhibited prolonged hepatic dysfunction and/or abnormal serological tests suggestive of autoimmunity, and they had some degree of basal vacuolar degeneration with or without lymphocytic infiltrates in the dermis, and atypical degeneration of small bile ducts at the same level as seen in acute GVHD ranging 20 to 50 micron in diameter. Chronic sialoadenitis with atypical epithelial degeneration was evident in two of them. A major cause of death was interstitial pneumonia of viral or fungal etiology due to persistent immunodeficiency.
 ...
PMID:A clinicopathological study of 15 autopsy cases with allogeneic bone marrow transplantation in special reference to graft versus host disease (GVHD). 352 10

The first cause of death in burned patients is still sepsis. A great number of studies point out a serious immunodeficiency due to several circulating mediators. Nowadays early excision and plasma exchange appear to be the most efficient procedures in order to remove from the patient these circulating agents. Therefore in this study the authors have treated 8 patients (average age 25 years), who presented an average of total burned surface of 49%, with plasma exchange performed early after injury. The results of PMN and lymphocyte function tests showed a significant therapeutic correction of these parameters in patients treated with plasma exchange. The clinical observations agreed with the results: in 7 patients with positive outcome, no invasive infections were recorded. The positive results obtained warrant further investigation with this procedure.
 ...
PMID:Prophylactic plasma exchange in burn treatment. 359 61


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>