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

Meningococcal meningitis as well as meningococcal sepsis must be regarded as complications of an otherwise mild meningococcal infection of the nasopharynx. Only individuals without antibodies against a given meningococcal type will contract the above-mentioned diseases. Causal prophylactic measures have proved to be ineffective because of the great number of "carriers" of meningococci. Immunprophylaxis with specific polysaccharides is effective and presently available for use against types A and C but not against type B. Chemoprophylaxis is most effective when administered to those living in close quarters. Sulfonamides are the prophylaxis of choice agianst meningococci sensitive to sulfonamides. With the appearance of sulfonamide-resistant meningococci, the sulfonamide must be replaced by rifamycin or minocyclin. Though treatment with penicillin gives protection against infection, it does not eradicate the carrier state.
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PMID:[Prevention of meningococcal meningitis]. 40 42

Eighty four cases of meningococcal infections are reviewed. Fifty seven cases presented themselfs as meningococcal meningitis, twelve cases as sepsis with moderate hypotension and 15 cases were sepsis with septic shock. A brief course of the disease, shock, echymosis, absence of meningeal signs, leucopenia and intravascular coagulation were findings more frequent in the group of patients with hiperacute sepsis, whereas other signs as fever, headaches, vomiting and petechiae were present with equal frequency in the three groups. N. meningitis was isolated in 73% of the cases. Shock (18.85%) and intravascular coagulation (12%) were the complications more frequently found, followed by convulsions (4.81%), arthritis (4.81%), skin necrosis (4.81%), subdural efusion (3.57%), cerebral palsy (3.40%), thrombophlebitis (1.20%), recurrence (1.20%), inapropiate antidiuretic hormone secretion (1.20%) and subaracnoideal hemorrage (1.20%). The overall mortality was 10.70% and 60% of the patients which initially presented with shock and intravascular coagulation died. Autopsy findings included wide spred hemorragic lesions and intravascular thrombi in skin, mucous membranes and viscera. Adrenal hemorrhage was present in five of the six cases studied.
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PMID:[Incidence, clinical, forms and complications of meningococcal infections (author's transl)]. 41 52

1. Where a purulent meningitis develops in association with a cyclic infectious disease (e.g. meningococcal meningitis), the prognosis is to be designated good, provided that it is diagnosed early and that no Waterhouse-Friderichsen syndrome is present and that adequate treatment is carried out. 2. In transmitted meningitis after purulent processes in the head region (sinusitis, otitis media), in addition to early diagnosis and antibiotic therapy the suppurating focus must also be cleared out in time. 3. The worst prognosis is for a purulent meningitis associated with sepsis, because here there must not only be early recognition and treatment of the meningitis, but also the recognition and treatment of the septic focus.
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PMID:[Influence of pathogenesis of purulent meningitis on the prognosis (author's transl)]. 82 5

A series of patients with meningococcal infections have been studied and divided in two groups: Group I patients with meningococcal sepsis and group II, those with meningococcal meningitis. Patients in group I presented with more severe encephalopathy, shock, DIC and acute systemic complications. Both groups showed a marked hypoaminoacidemia compared with normal controls (other than for the sulfur containing amino acids and phenylalanine). The concentration of aromatic and basic amino acids, the phenylalanine/tyrosine ratio, the transaminase levels and the negative nitrogen balance were higher in group I patients. The ratio of branched chain to aromatic amino acids was lower in group I. All these differences were statistically significant. The close association between the metabolic derangements and clinical manifestations may help in the understanding of several physiopathological aspects of meningococcal infections.
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PMID:Significance of the changes in plasma amino-acid levels in meningococcal infection. 365 98

Eighteen patients less than 15 years of age (range, 1.5 to 15 years) were followed prospectively after undergoing splenectomy for blunt trauma. Follow-up time ranged from 1 to 12 years with a mean of 5.8 years. During the follow-up period significant septic episodes developed in two of the 18 (11.0%) patients. During the same period 16 patients less than 15 years of age (range 2 to 15 years) who underwent splenorrhaphy were followed. In none of the patients in the splenorrhaphy group has sepsis developed to date (P = .11). Follow-up studies in both groups included a CBC, peripheral smear, platelets counts, history of infections, and radionuclide scans in the patients undergoing splenorrhaphy. The two patients with significant sepsis were an 18-month-old male with pneumococcal septicemia and a 13-year-old with meningococcal meningitis. Both patients survived these episodes. Although the numbers are small, this prospective study reemphasizes the increased risk of sepsis in the asplenic pediatric patient and the need for close surveillance, parental education, appropriate immunizations, and vigorous treatment of infections. The methods used in this prospective study of patients from one institution could be expanded to a multi-institutional study to obtain prospective data concerning the natural history of pediatric patients undergoing splenectomy because of trauma.
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PMID:Postsplenectomy sepsis in pediatric patients following splenectomy for trauma: a proposal for a multi-institutional study. 379 73

The authors analyzed the incidence of meningococcal diseases in the West Bohemian region in 1982-1996. The draw attention to changes of clinical and epidemiological characteristics of the disease which appeared in 1994 in conjunction with a new invasive clonus of Neisseria meningitidis C:2a:P1.2, P1.5, ET-15/37. While in 1982-1993 invasive meningococcal diseases had in 75% the course of meningitis with a relatively low fatality (4%), during the subsequent period a marked change occurred. Since 1994 the disease took in the West Bohemian region in 58% the course of sepsis with a fatality of 16%. 25% cases of meningococcal meningitis were diagnosed combined sepsis and meningitis in 17%. The disease lost its seasonal character and the authors confirmed the highest incidence of the disease in the age group from 15-19 years and 0-4 years. Neisseria meningitidis group C was detected in 1994-1996 in 73% and the invasive clone C:2a:P1.2, P1.5, ET-15/37 in 62%.
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PMID:[Changes in clinical and epidemiologic characteristics in Western Bohemia of invasive meningococcal disease associated with the occurrence of an invasive clone of Neisseria meningitidis]. 947 4

A case of Staphylococcus aureus meningitis (SAM) secondary to endocarditis is presented. The presence of a petechial rash affecting the lower limbs led to an initial presumptive diagnosis of meningococcal meningitis. There were no stigmata of endocarditis at presentation, though these subsequently developed. Underlying endocarditis should be diligently sought in any patient presenting with spontaneous SAM, even if typical stigmata are initially absent. In view of the association with skin lesions and neurological complications, S. aureus endocarditis may mimic the classical presentation of meningococcal sepsis.
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PMID:Staphylococcus aureus endocarditis presenting as meningitis and mimicking meningococcal sepsis. 1056 77

Metastatic meningococcal endophthalmitis, although rare, is a rapidly progressive and sight-threatening infection. We present a 10-month-old infant with meningococcal meningitis who developed unilateral metastatic endophthalmitis. If patients develop a sepsis-like picture with cloudy cornea and purulent conjunctivitis, we have to consider the possibility of endophthalmitis and full ophthalmological evaluations are indicated. Treatment should be started as early as possible. The outcome of endophthalmitis is frequently permanent visual impairment. Endophthalmitis is a true medical emergency requiring early antibiotic therapy with full dose of antimicrobials to avoid morbidity and blindness.
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PMID:Endophthalmitis as a complication of meningococcal meningitis: report of one case. 1091 May 99

A 3-year-old girl with phenotypic and cytogenetic manifestations of the ICF syndrome and DNA hypomethylation but without DNMT3B gene mutation is described. At age 3 months, she had an apneic spell that left her with spastic paraplegia and severe mental retardation. At age 8 months, she suffered meningococcal meningitis and sepsis. When seen by us at age 3 years with virilization, she had a cleft plate, macroglossia, and an atrial septal defect. An adenoma was surgically removed from the right adrenal cortex. Her serum immunoglobulin levels were normal except IgA at the low normal border. Her lymphocytes showed paracentromeric stretching of chromosomes 1 and 16 in 7% of metaphases, and multiradial figures involving these chromosomes in 1% of cells. Hypomethylation of classical satellite 2 DNA was observed with BstBI digestion, but in a lesser degree than those in the individuals with proven DNMT3B mutations. No mutation was found in the coding and promoter regions of the gene. Several alternative interpretations were considered to explain the low frequencies of chromosomal instabilities and the lower degree of DNA hypomethylation, and undetected DNA3B mutations. A mutation may be present in the gene but undetected, present in other DNA methyltransferases (DNMT) genes or in a DNMT-associated protein gene.
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PMID:ICF syndrome in a girl with DNA hypomethylation but without detectable DNMT3B mutation. 1532 30

Severe infections caused by Neisseria meningitidis, clinically appearing as meningitis or sepsis, are constantly noted in developed countries, including Poland. Because of rapid clinical course and mortality rate they continue to pose a serious clinical problem. Most cases are sporadic ones, caused by the contact with a healthy carrier of N. meningitidis. Familial and group outbreaks are rare, being responsible for about 1% of cases. However, in family members of patients with meningococcal infection the risk of developing the disease during the following week is about one hundred times higher than in the general population and they should receive an antibiotic prophylaxis. We describe a familial outbreak of meningococcal meningitis with typical clinical features, which appeared in two members of a family during the same day, with a case of acute pharyngitis most likely of the same etiology in the third person, a child. In that instance, practically simultaneous appearance of consecutive cases gave no time for prophylaxis. However, suspicion of meningococcal disease in the first patient contributed to the prompt hospitalization and diagnostics and proper treatment in the two following cases.
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PMID:[Meningococcal meningitis--familial outbreak]. 1575 42


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