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)

Two hundred patients assessed for nutritional deficiencies were analyzed for reaction to skin testing with common antigens and the incidence of sepsis and death. Only 39% of all skin tests were positive, though 50% of the patients had at least one positive test. Associated diagnoses revealed a high incidence of malnutrition, cancer, radiation therapy, and chemotherapy. Analysis using Chi-square and Gamma shows good statistical correlation between skin tests and sepsis and death. Those with negative tests (anergic) using PPD, Candida, and mumps had a threefold higher mortality. Major sepsis also increased in the skin negative group (+80%), but here the incidence varied directly with the number of positive skin tests. Mortality, unlike sepsis, was influenced only by the presence of delayed hypersensitivity and was not related to the number of positive reactions. The basic rate of infection or mortality was not influenced by major surgery.
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PMID:Delayed hypersensitivity on a surgical service. 318 56

This study examines host defense mechanisms in vascular surgery patients when admitted to the hospital to determine the frequency of abnormal host defense and the predictability of this information for septic-related mortality in affected patients. Sixty-four patients undergoing elective surgery (indications: 35 with aneurysms, 27 with aortoiliac disease, and two with renovascular disease) and nine patients undergoing emergency operation (indications: two with ruptured aneurysms, seven with aortoenteric fistulas) were skin tested when admitted to the hospital with five ubiquitous antigens (Candida, mumps, tuberculin, Trichophyton, and streptokinase-streptodornase [Varidase]) and read at 24 and 48 hours. Patients were anergic with none, relatively anergic with one, or reactive with two or more antigen responses (induration 5 mm). Eighty-nine percent of elective surgery patients were reactive, 5% were relatively anergic, and 6% were anergic. This compared with 64% reactive, 13% relatively anergic, and 17% anergic patients in a separate concurrent study of 565 surgical patients with gastrointestinal malignancies (p less than 0.001, chi 2). There were two septic-related deaths in the elective surgery group and both patients were anergic at admission, which resulted in a mortality rate of 50%. Two deaths not related to sepsis occurred in two reactive patients (4%). Logistic regression analysis predicted 3.9 deaths in the elective surgery group and four deaths were observed. Both patients with ruptured aneurysms were unreactive and both died of septic-related complications. Only one of seven patients admitted with an infected graft was reactive. All had surgery. Using the admission data of these seven patients, we predicted 2.3 deaths. Two deaths were observed 21 and 48 days after operation. Both patients were anergic and scored high probabilities of mortality (more than 0.6) at admission. The remaining emergency procedure patients scored lower probabilities of mortality (less than 0.4) at admission and none died.2+.
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PMID:Host defense mechanisms in elective and emergency vascular surgery: predicting septic-related mortality. 394 35

Epididymitis is the most common intrascrotal inflammation. Retrograde ascent of pathogens is the usual route of infection. Nonspecific bacterial epididymitis is caused by various aerobic bacteria, is frequently associated with anatomic abnormalities, and represents the most common type of epididymitis in older men. Sexually transmitted epididymitis is usually caused by Chlamydia trachomatis or Neisseria gonorrhoeae and represents the most frequent cause of acute scrotal swelling in men younger than 35 years of age. Underlying urologic abnormalities are uncommon in patients with sexually transmitted epididymitis. Systemic infections and trauma are unusual causes of epididymitis. Orchitis is less common than epididymitis. Blood-borne dissemination is the major route of testicular infection. With the exception of viral diseases, genitourinary tract infections seldom involve the testis primarily. Mumps is the most frequent cause of viral orchitis. Pyogenic orchitis usually results from an inflammatory process in the epididymis. Systemic dissemination of granulomatous infections may occasionally cause orchitis.
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PMID:Epididymitis, orchitis, and related conditions. 639 Jul 41

Syncytial giant cell hepatitis in the neonatal period has been associated with many different etiologic agents and may present initially as cholestasis. Infectious causes are most common and include: (1 ) generalized bacterial sepsis, (2) viral agents, (3) toxoplasmosis, (4) syphilis, (5) listeriosis, and (6) tuberculosis. Viral hepatitis may be due to cytomegalovirus, rubella virus, herpes simplex, HHV-6, varicella, coxsackievirus, echovirus, reovirus 3, parvovirus B19, HIV, enteroviruses, paramyxovirus, and hepatitis A, B, or C (rare). Giant cell hepatitis may result in fulminant liver failure with massive hepatocyte necrosis and severe liver dysfunction leading to death, resolution with severely compromised liver function, or liver transplantation. The authors report a 6-week-old male who had an unremarkable perinatal period, became jaundiced after developing diarrhea, and subsequently developed liver dysfunction with massively increased liver enzymes and a coagulopathy. Open wedge and core liver biopsies were performed to determine if the patient should be listed for liver transplantation. Giant cell hepatitis with a significant mixed lymphocytic and neutrophilic infiltrate was present on both the wedge and core biopsies. The residual 60% of hepatocytes had ballooning degeneration and many possessed pyknotic nuclei. The hepatocytes were arranged in a pseudoacinar pattern. Electron microscopy showed paramyxoviral-like inclusions in the giant cells, characterized as large inclusions with fine filamentous, beaded substructures (18-20 nm). Paramyxoviridae are nonsegmented, negative-sense, single-stranded RNA viruses. This family is divided into the Paramyxovirinae subfamily containing respirovirus (Sendai virus, parainfluenza virus type 3), rubulavirus (mumps, parainfluenza virus type 2), and morbillivirus genera (measles); and Pneumovirinae subfamily (pneumovirus genus [respiratory syncytial virus]). Supportive care to determine if hepatic function resolves following the viral episode, liver transplantation with fulminant liver failure, and ongoing evaluation in those who recover to assess chronic liver disease are necessary. Ultrastructural evaluation may unmask the etiologic agent for hepatitis and direct therapy.
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PMID:Neonatal syncytial giant cell hepatitis with paramyxoviral-like inclusions. 1129 22

Both neonates of male twins born at 30 weeks and 3 days gestation presented with late-onset sepsis caused by an infection with group B streptococci (GBS), shortly after one another. Although the younger twin recovered with a standard regimen of 10 days penicillin G i.v., the older twin had three recurrent episodes with GBS positive blood cultures. Oropharyngeal, faecal, urine, liquor and breast milk cultures were GBS negative. Using echocardiography and a PET/CT scan, a persistent endovascular focus was discovered. We treated him with penicillin G i.v. for 4 weeks, after which he recovered completely. Another male neonate born at 26 weeks gestation presented with GBS sepsis and developed an erythematous swelling of the right mandibula within 12 hours. Ultrasound revealed parotitis, which is rare in neonates (3.8 per 10,000). Risk factors for parotitis include prematurity, low birth weight and dehydration (i.e., diuretic usage). Parotitis can be complicated by abscess formation.
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PMID:[Neonatal sepsis caused by group B streptococci: atypical and recurrent disease episodes]. 2357 90

Intrauterine infections with the pathogens, including toxoplasmosis, other (syphilis, varicella, mumps, parvovirus, and HIV), rubella, cytomegalovirus, and herpes simplex (TORCH) in susceptible individuals during pregnancy, result in microcephaly, white matter disease, cerebral atrophy, and calcifications in the fetus. Pseudo-TORCH syndrome is an umbrella term, consisting of several syndromes, resultant from different genetic alterations and pathogenetic mechanisms. Band-like calcification with simplified gyration and polymicrogyria (BLC-PMG) is one of these conditions, resultant from biallelic mutations in the OCLN gene, located in the chromosome 5q13.2. OCLN gene encodes occludin, a tight junction protein, which is expressed in the endothelia. The absence of occludin in the developing brain subsequently results in abnormal blood-brain barrier, thus immune-cell mediated tissue damage and cortical malformation. Herein, we present a pediatric patient who had progressive microcephaly, spasticity, multi-drug resistant epilepsy, PMG and intracranial band-type calcifications, accompanied by central diabetes insipidus and renal dysfunction. Whole exome sequencing revealed a homozygote W58Ffs*10 (c.173_194del) frameshift mutation in the OCLN gene. Of 34 BLC-PMG cases with demonstrable OCLN mutations, only three had renal manifestations, which is responsible for the majority of the demises. This is the first case diagnosed as having central diabetes insipidus and responded to desmopressin treatment to the best of our knowledge, however, this clinical improvement could not prevent the patient from renal dysfunction. The patient deceased at four years of age from sepsis, therefore early diagnosis, optimal follow-up for renal involvement and infection prevention measures are necessary for the patients with BLC-PMG.
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PMID:A homozygote frameshift mutation in OCLN gene result in Pseudo-TORCH syndrome type I: A case report extending the phenotype with central diabetes insipidus and renal dysfunction. 3224 Aug 28

We propose the concept that administration of an unrelated live attenuated vaccine, such as MMR (measles, mumps, rubella), could serve as a preventive measure against the worst sequelae of coronavirus disease 2019 (COVID-19). There is mounting evidence that live attenuated vaccines provide nonspecific protection against lethal infections unrelated to the target pathogen of the vaccine by inducing "trained" nonspecific innate immune cells for improved host responses against subsequent infections. Mortality in COVID-19 cases is strongly associated with progressive lung inflammation and eventual sepsis. Vaccination with MMR in immunocompetent individuals has no contraindications and may be especially effective for health care workers who can easily be exposed to COVID-19. Following the lead of other countries conducting clinical trials with the live attenuated Mycobacterium bovis BCG (BCG) vaccine under a similar concept, a clinical trial with MMR in high-risk populations may provide a "low-risk-high-reward" preventive measure in saving lives during this unprecedented COVID-19 pandemic.
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PMID:Could an Unrelated Live Attenuated Vaccine Serve as a Preventive Measure To Dampen Septic Inflammation Associated with COVID-19 Infection? 3296 10