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

Biweekly 200 mg/kg infusions of immune globulin (Gamimune) were given to a 46-year-old woman with severe common variable immunodeficiency, bronchiectasis, and chronic diarrhea with malabsorption. Failure to achieve therapeutically effective serum IgG concentrations in the face of fulminant sepsis was accompanied by a shortened serum IgG half-life of 10.6 days. Currently recommended doses of 200 mg/kg may prove inadequate in very ill patients with sepsis and malabsorption.
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PMID:Intravenous immune globulin therapy. Treatment of a patient with severe immunodeficiency, chronic malabsorption, and fulminant septicemia. 392 22

Munchausen syndrome by proxy is a rare form of child abuse that can cause great diagnostic difficulties. We treated an 8-year-old boy who had recurrent polymicrobial sepsis over 6 years. An extensive evaluation to determine the infectious focus and to exclude immunodeficiency was carried out before it was determined that his mother had repeatedly introduced material containing faecal or vaginal bacterial flora into his intravenous lines.
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PMID:Recurrent nosocomial polymicrobial sepsis secondary to child abuse. 613 4

The sensitivity of blood culture isolates to the bactericidal activity of normal human serum (NHS) has been studied in 101 patients with gram-negative sepsis. These results were compared with clinical status and outcome, and to the presence of specific IgG or IgM antibodies to O antigens of bacteraemic strains in autologous serum. 23% of the strains were markedly resistant, 27% markedly sensitive and 50% intermediately sensitive to the bactericidal activity of NHS. Shock or death occurred more frequently in immunocompromised patients and those infected with serum-resistant strains. IgG antibody titres to O antigens were significantly lower in patients with serum-resistant organisms regardless of their immune status. Resistance to natural bactericidal antibodies and low immunogenicity of the infecting organism, plus immunodeficiency in the host, may account for apparent increased virulence of some gram-negative bacilli.
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PMID:Serum sensitivity of strains isolated and antibodies against O antigen in gram-negative bacteraemia. 618 63

Several theories have been advanced in an effort to explain immunologic suppression after thermal injury, that is monocyte production of immunoregulatory prostaglandins, activation of suppressor cells, production of suppressive serum factors and alteration in helper cell function. In the current study, cytofluorometric analysis was performed on peripheral blood mononuclear cells isolated from 30 severely burned individuals using a FACS IV cell sorter. Fluorescein labeled monoclonal antibodies were used to phenotype total T cells (OKT3+), helper cells (OKT-4+), suppressor cells (OKT-8+), monocytes (antimono.2+) and B cells (anti-Ia+). After burn injury, the most striking phenotypic alterations observed were a marked decrease in the number and percentage of total OKT3+ T cells and OKT4+ helper cells. No significant increases were observed in the OKT8+ suppressor cell subpopulation. Monocytes exhibited a transitory increase during the first 48 hours postburn which returned to normal by postburn day 7. The percentage of Ia+ cells were either normal or decreased in number during the course of the injury. An OKT-4 to OKT-8 ratio of less than 1.00 at 24 to 48 hours postburn may represent a reliable predictive index for death by sepsis. These data suggest that the syndrome of burn induced immunologic suppression may be better described as a "burn induced immunodeficiency syndrome," that is characterized by decreased numbers or function of Interleukin-2 producing helper cells, or both.
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PMID:Flow cytometric analysis of lymphocyte subpopulations after thermal injury in human beings. 623 69

Deficiencies in the immune system that lead to increased morbidity and mortality from infectious complications have been well documented in patients suffering from trauma, malnutrition, sepsis, and thermal injuries. We investigated the potential benefit of immune stimulation for preventing infection in such conditions in an animal model by evaluating three drugs: Corynebacterium parvum, thymopentin (TP-5), and CP-46,665. One-hundred eighty female guinea pigs were rendered immunodeficient by first inflicting a 30% total body surface burn and then placing the animals on diets with calories inadequate to maintain body weight. One half of the animals were then given one of the three immunomodulators on the first, third, and fifth days after burn injury, to try to reverse immunodeficiency. The remaining animals received saline solution injections. Animal responses were evaluated by inserting a clot containing Escherichia coli and Bacillus fragilis into their peritoneal cavity 6 days after burn injury. The animals were followed for 21 days after burn injury. Autopsies on those that died revealed peritonitis and/or pneumonia; autopsies on these that survived showed no pneumonia and there was consistent resolution of peritonitis. TP-5 and CP-46,665, but not C. parvum, significantly improved survival rates and mean survival time in those animals receiving 100 kcal/kg/day. TP-5 and CP-46,665 may be of benefit to the severely stressed, malnourished surgical patient who is at risk of bacterial infection.
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PMID:Immunomodulators in the treatment of peritonitis in burned and malnourished animals. 637 60

The immune system was studied in 30 cases of local infection (pneumonia) and 56 cases of generalized infection (sepsis). Predominantly children with immunologic deficiency of the humoral type (77% of the cases) characterized by unscheduled fatty transformation of the thymus, underdevelopment of B-zones of lymphoid organs, low level of IgM production and the lack of IgG and IgA production were found to die with pneumonia, whereas children with physiological immaturity of the immune system and in smaller numbers (41% of the cases) with deficiency of immunity of the cellular and phagocytic type as confirmed by immaturity of the thymic tissue or its dysplasia with hypoplasia of lymphoid organs died with sepsis. Immunological deficiency of the humoral type is accompanied by suppurative destructive lesions of the respiratory organs, immunodeficiency of the cellular and phagocytic type by necrotic changes in the septic focus and mucous membranes of the organs contacting the environment.
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PMID:[The immune system and its relation with infection process in children]. 660 38

In 1975-1982, autopsies of 201 patients dying with leukemias and other tumors of hemopoietic system revealed infectious complications in 68.6%, among them pneumonias in 46.8%, sepsis in 10.9%, and inflammatory-necrotic processes of the digestive tract in 19.4%. More frequent occurrence of infectious complications in acute leukemias (68-75%) as compared with chronic (61-70%), in lympholeukemias (70-75%) as compared with myeloleukemias (61-68%), and virus infections including generalized forms of herpes in lymphogranulomatosis (30.8%) was noted. The importance of immunodeficiency conditions and granulocytopenia in the development of infectious complications which were the immediate cause of death of 56.7% of those dying with leukemias and other tumors of the hemopoietic system is discussed. The increased role in the etiology of these complications of the opportunistic intestinal microflora frequently present in various associations and in combinations with other microbes and fungi is noted.
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PMID:[Infectious complications of leukemias and other tumors of the hematopoietic system]. 668 27

Delayed hypersensitivity skin testing was performed in 129 critically ill patients. Six intradermal antigens were used: tuberculin, candidin, varidase, epidermophytin, trichophytin and CCB (a polyvalent microbial vaccine from the Pasteur Institute). The response was judged as positive when one test or more were positive. Patients were devided in four groups: group A (40 cases): non-infected patients, a priori without immunodeficiency; group B (14 cases); suspected of immunodeficiency (cancers, hemopathies, collagen diseases receiving corticosteroids); group C (24 cases): decompensated chronic respiratory insufficienceis; group D (50 cases): overwhelming sepsis (septicaemias, septic acute respiratory distress syndromes, thoracic empyemas, purulent meningitis, peritonitis, mediastinitis). A significant diminution of delayed hypersensitivity was observed in groups B, C and D. No relation was found between delayed hypertensitivity and prognosis in groups C and D.
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PMID:[Cell-mediated immunity study by skin testing in 129 critically ill patients (author's transl)]. 698 93

Between August 1975 and January 1981, 106 patients thought to have persistent or recurrent hyperparathyroidism underwent a total of 108 parathyroid re-explorations at the National Institutes of Health. These 106 patients had a total of 175 previous operations for hyperparathyroidism (156 cervical and 19 mediastinal). Nephrolithiasis (54% of patients) and bone disease (24% o patients) were the predominant symptoms. Arteriographic examination and selective venous sampling provided highly accurate localizing results in 33% of the patients, and were of some help in 64%. The final diagnoses after reoperation and re-evaluation were: single-gland disease in 58 patients, primary nonfamilial hyperplasia in 19 patients, familial hyperplasia in three patients, multiple endocrine neoplasia (MEN) Type I in ten patients, MEN Type II in two, parathyroid carcinoma in four patients, secondary hyperplasia in three patients, and familial hypocalciuric hypercalcemia (FHH) in two patients. The diagnosis was in doubt in five patients. In the 95 patients with unequivocal hyperparathyroidism, not due to parathyroid carcinoma, surgery eliminated hypercalcemia in 91 (96%). Two patients died after operation, one of disseminated candidiasis, and one patient, with an immunodeficiency, of sepsis. Five patients developed temporary, and one permanent, recurrent nerve damage; 41% of the patients were hypocalcemic, at the time of discharge from the hospital.
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PMID:Results of reoperation for persistent and recurrent hyperparathyroidism. 730 78

In this report, we present a 5 months old male baby, who suffered from watery diarrhea since 4 days old. From then on, he had been admitted 3 times in 3 different hospitals but the symptoms still bothered him off and on. During the days of hospitalization, sepsis with positive blood culture of Klebsiella was noted. The patient expired at 5 months of age. The T cell count was 20% active T was 0. Delayed hypersensitivity skin tests including Candida (10 X), PHA (10 micrograms), PHA (1 microgram), SK/SD (50 units) were negative. The granulocyte function study showed normal. Immunoglobulin analysis revealed IgG: 1320 mg%, IgA: 120 mg%, IgM: 100 mg%. Agenesis of thymus, failure of lymphoid differentiation and abnormal lymphoid architecture with absence of germinal centers were noted at autopsy. Combined immunodeficiency with normal immunoglobulins (Nezelof syndrome) is a disease of primary immunodeficiency characterized by recurrent infections, failure to thrive, lymphopenia, diminished lymphoid tissue, abnormal structure or agenesis of the thymus, and presence of normal or increased levels of one or more of the major immunoglobulin classes, but with impaired antibody synthesis. Since its original description by Nezelof and associates in 1964, it has been reported on the subsequent occasion. In this report, we present our one experience and review the clinical and laboratory data in 33 reported cases.
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PMID:Report of a case of Nezelof syndrome. 744 23


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