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)

A nineteen-month-old child presented with a febrile illness, skin rash, painful swelling of the joints, lymphadenopathy and hepatosplenomegaly. Pseudomonas was cultured from the blood during life and, subsequently, at autopsy. Autopsy revealed a generalized panarteritis involving the coronary, retroperitoneal and pulmonary arteries with thickening of arterial walls and narrowing of the lumina. Thrombi and foci of necrosis and infarcts were found in many organs. Numerous bacilli were present in fresh lesions, but not in the organizing lesions. Periodic acid-Schiff-positive deposits were found in occasional macrophages, in walls of affected vessels, in the marginal sinuses of lymph nodes and diffusely in epicardial and retroperitoneal adipose tissue. The findings suggest that some or even all cases of Kawasaki's disease and infantile polyarteritis nodosa may be caused by Pseudomonas sepsis. It is also suggested that the vasculitis and paucity of inflammatory reaction in many cases of Pseudomonas sepsis might be related to the fact that many strains of Pseudomonas produce high-molecular-weight levan (or another polysaccharide). This compound is known to inhibit the inflammatory reaction and to increase bacterial pathogenicity.
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PMID:Kawasaki's disease and infantile polyarteritis nodosa: is Pseudomonas infection responsible? Report of a case. 3 42

Two cases of atypical Kawasaki disease are reported. Case 1 was a five-month-old male infant admitted to this hospital with a 10-day's history of high fever. On examination, he appeared ill-looking and only hepatomegaly was noted. Laboratory studies showed leukocytosis, thrombocytosis, elevated ESR and pleocytosis in CSF. He was treated as sepsis with meningitis. Sudden death occurred on the eighth day of admission, and left coronary artery aneurysm with thrombosis was noted at autopsy. Case 2 was a four-month-old male infant referred to our hospital with fever and cervical lymphadenopathy of 11 day's duration, and unresponsive to antibiotics. Skin rash had developed after oxacillin injection. Echocardiogram, performed on the third day of admission, disclosed a 5-8 mm aneurysm of the left coronary artery and a 4 mm aneurysm of the right coronary artery. Before a specific diagnostic test for Kawasaki disease becomes available, we suggest that a possible diagnosis of Kawasaki disease and echocardiographic evaluation should be considered in case of (1) presence of partial criteria of Kawasaki disease with thrombocytosis; and/or (2) young infants with prolonged unexplained fever.
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PMID:Atypical Kawasaki disease: report of two cases. 151 14

A male infant and a three year old girl, both with acute febrile illness, were admitted to our hospital for suspected meningitis/sepsis and gastroenteritis/severe viral infection, respectively. Both showed all six principal features of Kawasaki syndrome and revealed several other symptoms and laboratory findings commonly associated with the disease. The infant had multiple coronary aneurysms. The girl developed ascites, pancreatitis and iritis, all of which are seldomly recognized symptoms of the Kawasaki syndrome. The prompt and satisfactory therapeutic responses of both patients to the combined therapy consisting of oral acetylsalicylic acid (50-100 mg/kg b.w./d) and intravenous gamma-globuline (400 mg/kg b.w./d) at the eight and even eleventh day of illness support the use of gamma-globuline therapy beyond the first week of the disease. Prior to their illnesses both children had been exposed to carpet shampoo, an agent which has been repeatedly associated with an increased risk of Kawasaki syndrome.
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PMID:[Kawasaki syndrome. Association with exposure to carpet shampoo and successful therapy with immunoglobulins in the second week of the illness]. 161 54

The availability of safe and effective preparations of human immune globulin that can be administered intravenously has revolutionized replacement therapy for patients suffering from hypogammaglobulinaemia. Of equal importance and greater interest, however, has been the recognition that super physiological doses of IgG can manipulate an abnormal immune system. Future prospects for the use of immunoglobulin preparations to supply specific antibodies includes the standardization of procedures, whereby patients with acute sepsis may receive antibiotics and immunoglobulin simultaneously. Already there is in vitro evidence that suggests that opsonized bacteria are more readily affected by aminoglycosides. It seems certain that gamma globulin will be used routinely in the management of patients with a number of immunomalignancies, such as chronic lymphatic leukaemia and multiple myeloma that feature hypogammaglobulinaemia, especially when chemotherapy is being administered. Control trials are underway to determine whether gamma globulin given intravenously to premature babies will satisfactorily correct their immuno-deficient state and improve their chances of survival. The immunomanipulative capacity of immunoglobulin is yet to be fully realized. Success in ideopathic thrombocytopenic purpura had led to a trial of gamma globulin in a number of autoimmune conditions. Success has been reported in myasthenia gravis, rheumatoid arthritis, diabetes, patients with circulating antibodies to factor VIII and Kawasaki's disease. The mechanism of action is unknown but almost certainly multifactorial. Two proven mechanisms that will be added to in the future, include blockade of the Fc receptors on cells of the reticulo-endothelial system and manipulation of immunoregulatory T cells by the presence of anti-idiotypic antibodies in the preparation.
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PMID:The clinical use of intravenous gammaglobulin. 244 Jul 43

At the present time there are three commercially available intravenous immunoglobulin (IVIG) preparations. There is no distinct therapeutic advantage for any one product over any other. Intravenous immunoglobulin is currently approved for the treatment of antibody deficiency syndromes and for acute and chronic idiopathic thrombocytopenic purpura. In addition, controlled clinical trials have demonstrated efficacy for the treatment of Kawasaki disease and for the prevention of the following infections: sepsis in preterm neonates, sepsis in infants with AIDS, and cytomegalovirus infection in the immune-compromised host. Open (uncontrolled) studies have suggested benefit in the treatment of neonatal sepsis, chronic Epstein-Barr virus infection, and a number of autoimmune diseases. Additional carefully designed studies must be completed before IVIG therapy can be recommended for these latter categories. In published reports, dosage of IVIG and intervals between infusions have varied considerably. For all current indications, the physician must therefore individualize treatment and thoroughly review any recent literature that may clarify guidelines to IVIG therapy. Significant adverse reactions are rare but high cost remains the main obstacle to more routine implementation.
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PMID:Intravenous immunoglobulin: new clinical applications. 282 63

Coronary arteries in six children who had Kawasaki disease but lacked coronary arterial aneurysms were examined. Four children died of myocarditis at the acute stage, and two children died of bacterial sepsis or as a result of an occurrence during cineangiography at the healed stage. Twenty-one children without Kawasaki disease were examined as controls. The six children with Kawasaki disease had no thrombi, recanalization, or stenosis greater than 50% in the major coronary arteries. Three patients had dilatation of the major coronary arteries at the acute stage. Two of the three patients died during the acute stage, and autopsy showed slight dilatation of coronary arteries and abnormal intimal thickening due to panvasculitis. In the third child, who died at the healed stage, dilatation of the coronary arteries detected by two-dimensional echocardiography at the acute stage had disappeared at the healed stage. No dilatation of the major coronary arteries was seen at autopsy. However, abnormal fibrous intimal thickening of the major coronary arteries without inflammatory changes was found. The other three patients had no dilatation of the major coronary arteries at the acute stage. Two patients died at the acute stage, and slight inflammation without abnormal intimal thickening was seen in the intima and the adventitial area. In the third patient, who died during the healed stage, two-dimensional echocardiography revealed no dilatation during the clinical course, and there was no inflammatory changes or abnormal intimal thickening at autopsy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pathological features of coronary arteries in children with Kawasaki disease in which coronary arterial aneurysm was absent at autopsy. Quantitative analysis. 339 71

In a 9-month prospective study conducted in an urban emergency room, 15 children with rectal temperature greater than 41.1 degrees C (106 degrees F) were evaluated. Seven of the 15 patients were admitted to the hospital. Two children who were discharged home required subsequent admission, and six were managed on an ambulatory basis. Eight (53.3%) children had serious disease: two bacterial meningitis, two bacteremia without meningitis, two pneumonia, one pericarditis with effusion, and one Kawasaki disease. In four, the final diagnosis indicated a much more serious illness than was considered initially. The laboratory studies did not correlate reliably with the final diagnosis or need for admission. Children with a rectal temperature greater than 41.1 degrees C are at high risk for a life-threatening illness and should be evaluated for sepsis and meningitis.
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PMID:Association of temperature greater than 41.1 degrees C (106 degrees F) with serious illness. 396 27

Experiments aimed at producing a model of Kawasaki's disease by injecting animals intraperitoneally with Pseudomonas bacilli are described. Injection of large numbers of bacilli into mice caused rapidly fatal sepsis. With appropriate numbers of organisms, some mice died within 3 days, most remained healthy, while in some an inapparent chronic disease developed. Positive blood cultures were occasionally obtained 4-17 weeks after the slow infection. An alcohol-precipitable polysaccharide, which could be measured by Roe's procedure for levan, was found in 20% of the experimentally infected mice. We suggest that this substance was partly responsible for the course of the infection. Severe vasculitis with little acute inflammatory reaction and carditis with coronary aneurysms were often obtained by injecting mice and guinea-pigs with supraliminal doses of bacilli at the same time as their immune system was impaired by treatment with either nitrogen-mustard or cyclophosphamide. We suggest that pseudomonas infection in immunologically deficient animals may mimic Kawasaki's disease and that a similar mechanism may operate in the natural form of the disease in children.
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PMID:Can pseudomonas infection in experimental animals mimic Kawasaki's disease? 654 20

Cefotetan (CTT), a new cephamycin antibiotic, was administered to 21 pediatric patients, 1 year and 1 month to 9 years of age, with moderate or severe infections. CTT was intravenously administered 3 times a day at daily doses of 26.5 to 120 mg/kg for 2 to 14 days, and 0.75 to 31.0 g of the drug were totally given. Total of 21 cases, 12 cases of respiratory tract infections (each 1 case of acute pharyngitis, acute tonsillitis and asthmatic bronchitis, 6 cases of acute pneumonia, 1 case of lung fibrosis and 2 cases of primary atypical pneumonia), 2 cases of urinary tract infections, 1 case of acute appendicitis, 1 case of perianal abscess, 2 cases of sepsis, 1 case of MCLS, 1 case of ReYE's syndrome and 1 case of meningoencephalitis, were received CTT. Five cases were excluded for the evaluation of clinical efficacy, and good response were obtained in 11 cases (effective rate of 68.8%), fair in 1 and poor in 4. Out of 3 strains of causative organisms isolated before the treatment, H. influenzae and K. pneumoniae were disappeared after the CTT treatment, S. faecalis which was resistant against CTT persisted. Neither adverse effects nor abnormal laboratory findings were observed except 1 case of eosinophilia.
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PMID:[Clinical evaluation of cefotetan in pediatrics]. 658 32

The clinical and laboratory findings in seven children with Kawasaki disease are reviewed. Four of the patients had the more complicated course that has characterized the cases diagnosed in North America. This suggests that the benign forms are often mistaken for other febrile illnesses. The patients were two girls and five boys ranging in age from 4 months to 7 years; six were Caucasian and one was a North American Indian. Fever, redness of the oral mucosa, an erythematous or scarlatiniform rash and cervical adenopathy were seen in all; six patients had the characteristic fingertip desquamation and nonexudative conjunctivitis. Cardiac involvement occurred in four patients, two of whom had coronary artery aneurysm or thrombosis. Arthritis or arthralgia was seen in six patients, and aseptic meningitis occurred in four. Of the three patients with jaundice two underwent laparotomy and excision of a hydropic gallbladder; one of them died from Klebsiella pneumoniae sepsis and disseminated intravascular coagulopathy.
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PMID:Kawasaki disease, or mucocutaneous lymph node syndrome: report of seven cases in North America. 737 Aug 80


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