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

Fusobacterium necrophorum is a strict anaerobic organism responsible for a number of clinical syndromes known as necrobacillosis. Although meningeal infections with anaerobes are rare, delayed diagnosis and treatment can be potentially fatal. We report a unique case of Fusobacterium meningitis, mastoiditis, and sepsis in a previously healthy adolescent. Diagnosis and management of this condition are discussed in the context of a literature review.
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PMID:Otogenic Fusobacterium meningitis, sepsis, and mastoiditis in an adolescent. 1510 42

Acute otitis media is a widespread disease affecting all ages. The introduction of antibiotics has led to a reduction in the incidence of complications from approx. 17% to 1%. Nevertheless, life-threatening complications still occur. The present paper describes the course and treatment of mastoiditis, petrositis and sepsis, as well as intracranial complications, i.e. meningitis, sigmoid sinus thrombosis, extradural abscess, subdural empyema, brain abscess and otitic hydrocephalus. The importance of antibiotic treatment for acute otitis media and the need to assess treatment outcomes are emphasised.
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PMID:[Acute otitis media and its life-threatening complications]. 1559 96

Pseudomonas aeruginosa septicemia is rare in healthy infants and children. Also not common, dermatologic manifestations such as ecthyma gangrenosum and indurated erythematous nodular lesions may be the first signs of pseudomonas infection, or may appear later in the course of the disease. Peripheral facial paralysis and mastoiditis are also rare and serious complications of acute otitis media caused by P. aeruginosa. We report a previously healthy 6-month-old boy who had an uncommon presentation and rare complications during the course of P. aeruginosa sepsis.
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PMID:Multiple erythematous nodules and ecthyma gangrenosum as a manifestation of Pseudomonas aeruginosa sepsis in a previously healthy infant. 1678 Apr 71

This report presents the case of a healed 5-month-old infant with necrotising (malignant) bilateral otitis externa from acute mastoiditis on the right side and sepsis caused by Pseudomonas aeruginosa infection. Despite of immediately performed mastoidectomy, targeted antibiotics and intensive local treatment, two third of both external auditory canal's epithelium had shown subcutaneous concentric necrosis and ejection which have been removed with repeated necretomies. After the remission of inflammatory symptoms, successful bilateral auditory canal reconstructions were performed. The observed right peripheral facial paresis at the beginning of disease remained stationary. The patient healed with residual symptoms after 2 months of treatment. Neither immune deficiency, nor diabetes could have been proven.
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PMID:[Necrotizing otitis externa in a 5-month-old infant]. 1798 26

Cunninghamella bertholletiae infection occurs most frequently in neutropenic patients affected by haematological malignancies, is associated with an unfavourable outcome. We report a case of rhino-mastoidal fungal infection in a leukaemic patient. Bioptical tissue cultures yield the isolation of a mould with typical properties of Cunninghamella species. Liposomal amphotericin B (L-Amb) therapy combined with surgical intervention brought the lesion to recovery. Nevertheless, the patient died 14 days after bone marrow transplantation (BMT) from bacterial sepsis. Mastoiditis was documented at CT-scan. The conditioning regimen probably caused the reactivation of the Cunninghamella infection that led to the patient's fatal outcome; fungal hyphae were detected after autopsy of brain and lung tissue.
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PMID:A case of Cunninghamella bertholettiae rhino-cerebral infection in a leukaemic patient and review of recent published studies. 1834 May 46

Thrombophlebitis of dura venous sinuses is a rare intracranial complication of otitis media, which may be sometimes accompanied by symptoms or sepsis. Anatomical conditions and early diagnosis of this vascular complication determine the treatment modality. Aim of this study was the assessment of diagnostics and treatment of venous sinuses thrombophlebitis in acute and chronic otitis media considering anatomy and the venous sinuses and status of coagulation system. Otogenic thrombophlebitis may occur in lateral, transverse, upper and lower petrosal sinuses, and rarely in cavernous. In some cases thrombophlebitis proces may expand into brain or emissary mastoid veins. Lateral sinus thrombophlebitis in chronic otitis media usually appears clinically as septic fever, earache, and increasing neurologic signs. In acute otitis media when thrombophlebitis develops the patient complains about headache, high fever and visual acquity. Diagnosis of venous sinus thrombophlebitis is based on clinical signs, radiological imaging (CT scan, MRI), bacteriological examinations and laboratory biochemical tests. Contrast enhanced CT scan shows "delta sign". Septic thrombophlebitis sinus sigmoidei is caused by mixed bacterial flora. Surgical treatment in cases with septic thrombus consists of radical modiffied ear operation and lateral sinus exposure. Thrombectomy and jugular vein ligation is performed when sepsis or thrombus is present. Mastoidectomy and tympanic cavity drainage is performed in cases with lateral sinus thrombosis in acute mastoiditis. Intravenous antibiotics therapy should be continued for 2 weeks. Anticoagulants should be given taking into consideration parameters of coagulation system and the type of thrombus. Treatment results of venous sinuses thrombophlebitis are good if they are not accompanied by other intracranial complications.
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PMID:[Thrombophlebitis of venous sinuses in otitis media]. 1855 16

The aim of the present report is to review the complications of the deep neck infections and their surgical treatment in the Institute for the last 5 years. From 1999 to 2003 29 patients with deep cervical infections were treated surgically. Twelve of the patients had submandibular abscess, 10 cases were with parapharyngeal abscess, 3 with Ludwig's angina, 1 with mastoiditis with exteriorization in the neck and 3 with neck phlegmonas. The infections were most frequently oftonsillar and dental origin. The following complications were observed: 6 cases with acute obstruction of the upper airways treated with tracheostomy; 2 cases with sepsis; 2 with descending mediastinitis; and 1 with acute hemorrhage of stress ulcers of the stomach. Three cases of deep cervical infections, complicated with mediastinitis, sepsis, VII and XI cranial nerves paresis, hemorrhages from the gastrointestinal tract are cited. The third case is interesting with the multiple complications including hemorrhage from stress ulcers of the stomach, which could not be managed endoscopically because of the compression due to hypopharingeal edema leading to laparotomy, gastrotomy and suture of 3 stress ulcers. Later, the development of mechanical ileus based on adhesions was treated with ileostomy and laparostomy. The great importance of the early surgical treatment of neck infections, the use of antibiotics covering both aerobic and anaerobic bacterial spectrum and the good coordination between otolaryngologists, surgeons, anestesists and microbiologists is stressed in conclusion.
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PMID:[Surgical complications of the deep infections of the neck]. 1869 31

Deep infections of the neck are potentially life-threatening for their descending spread along cervical fascia planes towards the mediastinum and development of sepsis after thrombophlebitis of the internal jugular vein. The aim of the present report is to review the complications of the deep neck infections and their surgical treatment for the period of the last 5 years. From 1999 to 2003 29 patients with deep cervical infections were treated surgically. Twelve of the patients had submandibular abscess, 10 cases were with parapharyngeal abscess, 3 with Ludwig's angina, 1 with mastoiditis with exteriorization in the neck and 3 with neck phlegmonas. The infections were most frequently of tonsillar and dental origin. The following complications were observed: 6 cases with acute obstruction of the upper airways treated with tracheostomy; 2 cases with sepsis; 2 with descending mediastinitis; and 1 with acute hemorrhage of stress ulcer of the stomach treated with laparotomy and laparostomy. Combined surgical and massive antibiotic treatment according to the bacteriological findings was carried out. Cervical incisions, jugulotomy and thoracotomy were performed in cases with descending mrdiastinitis. Permanent suction drainage and lavage of the abscess cavities were used. In cervical phlegmonas the surgical wounds were left open against anaerobic infection. Three cases of deep cervical infections, complicated with mediastinitis, sepsis, VII and XI cranial nerves paresis, hemorrhages from the gastrointestinal tract are cited. The third case is interesting with the multiple complications of the deep neck infection--stress ulcer of the stomach, which could not be managed endoscopically because of the compression due to hypopharingeal edema, sepsis, tracheal stenosis. All the patients but one recovered after the treatment. One of them with cervical phlegmona died out of heart arrest in the operating theater after urgent intubation and tracheotomy for airway obstruction. The great importance of the early surgical treatment of neck infections, the use of antibiotics covering both aerobic and anaerobic bacterial spectrum and the good coordination between otolaryngologists, surgeons, reanimators and microbiologists is stressed in conclusion.
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PMID:[Complications of the deep infections of the neck]. 1878 14

Subdural empyema is a rare form of intracranial sepsis associated with high morbidity and mortality. The most frequent cause is extension of paranasal sinusitis through emissary veins or of mastoiditis through the mucosa, bone, and dura mater. Development of subdural empyema after pyogenic meningitis is known to be very unusual in adults. We report a rare case of fatal subdural empyema, an unusual complication of pyogenic meningitis. Our bitter experience suggests that subdural empyema should be borne in mind in patient with pyogenic meningitis who exhibit neurological deterioration.
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PMID:Fatal subdural empyema following pyogenic meningitis. 2155 39

16S rDNA polymerase chain reaction (PCR) in the diagnosis of fastidious organisms is becoming increasingly commonplace. We present the case of a child admitted to an acute paediatric unit of a university teaching hospital with otorrhoea, torticollis, and cervical lymphadenopathy. Examination revealed hepatosplenomegaly associated with pancytopenia. Radiological imaging confirmed a retropharyngeal abscess, bilateral mastoiditis, cerebellar lesions, and venous sinus thrombosis. Swabs of aural discharge grew anaerobes. Drainage of the retropharyngeal abscess and bilateral mastoidectomy were performed. Bone marrow aspiration was initially suspicious of acute leukaemia prompting further investigations, but cytogenetic analysis ruled out this diagnosis and changes were attributed to severe sepsis. Following 27 days of intravenous antibiotics and after clinical improvement, clindamycin was started. Intraoperative pus yielded no significant pathogens. A 16S rDNA PCR confirmed Fusobacterium necrophorum. The boy was discharged on a 6 week course of oral clindamycin.
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PMID:Unusual findings and diagnostic challenges in a child with Lemierre's disease. 2183 43


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