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

The authors have observed three instances of sepsis due to Mycobacterium fortuitum complicating total hip replacement for osteoarthritis. The case histories are fully described. The requirements are given for recognition of the organism which grows on special culture media and which may be mistaken for Mycobacterium tuberculosis. This feature explains why, in some cases, the organism may not be discovered. Antibiotics were ineffective but the general condition of the patient was not greatly affected.
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PMID:[Mycobacterium fortuitum infection after total hip prosthesis. A report of 3 cases (author's transl)]. 15 87

A 73-year-old patient with a cerebral abscess of tuberculous etiology localized in the left parietooccipital region is presented. Clinically it had behaved like an expansive process. The inside of the abscess contained a purulent exudate with polynuclear cells and necrotic material. The wall of the abscess was formed by a predominantly histiocytic internal layer and an external one composed by histiocytes with the morphology of epithelioid cells. No tuberculous granulomas were found. The histiocytes contained a large number of acid-alcohol resistant bacilli. In the exudate Mycobacterium tuberculosis hominis was bacteriologically isolated. After the surgical operation the patient developed an acute tuberculous sepsis with tuberculous exudative meningitis and miliary dissemination in various organs. As regards the pathogenesis of the tuberculous cerebral abscess the authors consider the possible influence of a deficitary immune state of the patient and the aggressiveness of the infective organism.
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PMID:[Tuberculous cerebral abscess. Morphopathologic study (author's transl)]. 49 87

Tumor Necrosis Factor (TNF) has been implicated in the early metabolic events following acute tissue injury or sepsis; it increases blood levels of glucocorticoids and glucagon or the cellular responses to the hormones. To examine whether stress-related hormones have any effect on macrophage activation by TNF, human monocyte-derived macrophages were exposed to somatostatin (S), ACTH, angiotensin (An), insulin (I), epinephrine (E), and glucagon (G) at physiologic concentrations. 125I-TNF binding as well as the ability of TNF to activate macrophages to kill an intracellular pathogen (Mycobacterium avium) were measured. While treatment with recombinant interferon gamma increased the number of TNF receptors by 53 +/- 8%, E, I, G, S, ACTH and An decreased the number of receptors by 81 +/- 6%, 83 +/- 6%, 15 +/- 5%, 83 +/- 4%, 17 +/- 4% and 21 +/- 4%, respectively. Treatment with I, E, and S also decreased the ability of macrophages to kill M. avium by 30 +/- 1%, 20 +/- 6%, and 51 +/- 2%, respectively. These in vitro results suggest that stress hormones influence TNF-mediated activation of macrophages.
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PMID:Effect of stress-related hormones on macrophage receptors and response to tumor necrosis factor. 197 Oct 32

The risk of causing or reactivating pelvic infection by hysterosalpingography (HSG) was assessed in 118 infertile women. Serological evidence of Chlamydia trachomatis infection was sought before, and 10 days and 4 weeks after HSG, using the single-antigen whole-inclusion immunofluorescence (WIF) test for species-specific antibody and the complement fixation test (CFT) for group antibody. Chlamydia antigen was detected using an ELISA. There was a close correlation between the finding of occlusive tubal damage and serum antibodies to C.trachomatis detected by both tests (P less than 0.001). Of 60 patients with WIF antibody titres greater than or equal to 1/64, 65% had evident tubal damage compared with only 16% of patients without a raised titre. Clinically suspected sepsis after HSG occurred in 4% of cases both with and without antibodies to C.trachomatis but only in those with tubal damage (10%). There was no serological evidence of C.trachomatis involvement in symptomatic or asymptomatic patients and anaerobic pathogens were isolated more commonly than C.trachomatis in those symptomatic cases. Isolation of C.trachomatis in two cases from the endocervix and also from the endometrium in one of these only after HSG was compatible with reactivation but not reinfection. Mycobacterium tuberculosis was isolated in two out of three cases with unsuspected tubal disease without antibodies to C.trachomatis. The risk of infection from HSG appears to be confined to patients with existing tubal damage, and in those unexpected cases without serological evidence of previous chlamydial infection, tuberculosis seems to be a likely cause.
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PMID:Chlamydia trachomatis, tubal disease and the incidence of symptomatic and asymptomatic infection following hysterosalpingography. 211 32

For years, quantitative blood cultures found only limited use as aids in the diagnosis and management of septic patients because the available methods were cumbersome, labor intensive, and practical only for relatively small volumes of blood. The development and subsequent commercial availability of lysis-centrifugation direct plating methods for blood cultures have addressed many of the shortcomings of the older methods. The lysis-centrifugation method has demonstrated good performance relative to broth-based blood culture methods. As a result, quantitative blood cultures have found widespread use in clinical microbiology laboratories. Most episodes of clinical significant bacteremia in adults are characterized by low numbers of bacteria per milliliter of blood. In children, the magnitude of bacteremia is generally much higher, with the highest numbers of bacteria found in the blood of septic neonates. The magnitude of bacteremia correlates with the severity of disease in children and with mortality rates in adults, but other factors play more important roles in determining the patient's outcome. Serial quantitative blood cultures have been used to monitor the in vivo efficacy of antibiotic therapy in patients with slowly resolving sepsis, such as disseminated Mycobacterium avium-M. intracellulare complex infections. Quantitative blood culture methods were used in early studies of bacterial endocarditis, and the results significantly contributed to our understanding of the pathophysiology of this disease. Comparison of paired quantitative blood cultures obtained from a peripheral vein and the central venous catheter has been used to help identify patients with catheter-related sepsis and is the only method that does not require removal of the catheter to establish the diagnosis. Quantitation of bacteria in the blood can also help distinguish contaminated from truly positive blood cultures; however, no quantitative criteria can invariably differentiate contamination from bacteremia.
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PMID:Quantitative aspects of septicemia. 220 Jun 6

Mycobacterial infections of the hand and wrist are rare. Concurrent infection of a joint by more than one organism is also unusual. A 25-year-old man developed wrist sepsis caused by Neisseria gonorrhoeae and Mycobacterium avium intracellularis. The infection was successfully treated by wrist drainage, carpal debridement, and intravenous antibiotics. Secondary carpal reconstruction was accomplished by delayed bone grafting and internal fixation to preserve radiocarpal motion.
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PMID:Mixed gonococcal and mycobacterial sepsis of the wrist. 237 49

Congenital tuberculosis is a rare disease of variable incidence in accordance with prevalence of the disease in the general population. We report a case in a neonate born prematurely, whose mother presented with miliary tuberculosis diagnosed in the puerperal period. The newborn had no contact with his mother after delivery, neither with other infected people. The clinical picture consisted mainly in signs and symptoms of septicaemia of gradual onset. Mycobacterium tuberculosis was isolated from gastric fluids and the response to specific treatment, was excellent. Although congenital tuberculosis is a rare disease, is should be suspected in any neonate developing signs and symptoms of sepsis of unknown etiology. The importance of an early diagnosis and treatment is stressed in order to improve neonatal survival.
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PMID:[Congenital tuberculosis]. 248 25

Bacterial infections are lethal complications of neutropenia, and antibiotics alone are inadequate therapy for these infections. Irradiated mice become severely neutropenic and remain susceptible to infection for 2 to 3 weeks, depending on the dose and quality of radiation. Some bacterial cell wall derivatives stimulate nonspecific host defense mechanisms against a variety of microbes which might cause postirradiation infection. In this study we determined if the cell wall glycolipid trehalose dimycolate (TDM), derived from Mycobacterium phlei, or a synthetic preparation of TDM was able to (i) enhance survival in mice when given before or after lethal doses of 60Co radiation and (ii) increase nonspecific resistance to postirradiation infection. Treatment with TDM oil-in-water emulsions and with synthetic TDM significantly enhanced survival before and after lethal doses of 60Co irradiation. This result correlated with the ability of TDM to reduce the translocation of intestinal bacteria and to stimulate hematopoiesis. With respect to nonspecific resistance to infection, TDM injected 1 h after sublethal irradiation increased resistance to a lethal Klebsiella pneumoniae challenge (10 50% lethal doses of K. pneumoniae in 30 days [LD50/30]) 4 or 14 days later. Increasing the dose of K. pneumoniae to 5,000 LD50/30 on day 4 overwhelmed the ability of TDM-treated mice to overcome infection. However, TDM treatment 1 h postirradiation combined with ceftriaxone antibiotic therapy (days 5 through 14) enhanced survival, even when the higher dose of bacteria (5,000 LD50/30) was used. These results indicate that in irradiated mice, TDM can be used to enhance survival and, as a potent stimulant of nonspecific resistance to infection in neutropenic mice, can act synergistically with antibiotic therapy to reduce sepsis and mortality.
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PMID:Trehalose dimycolate enhances resistance to infection in neutropenic animals. 266 26

One case of deep sepsis from Mycobacterium tuberculosis occurring two years after total hip replacement is reported. The patient had no history of previous tuberculous infection nor showed any sign of systemic disease at the time of surgery. The clinical and pathogenic implications are discussed.
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PMID:Deep sepsis from Mycobacterium tuberculosis after total hip replacement. Case report. 338 40

Primary bacteremia due to Mycobacterium fortuitum is an uncommon occurrence. Four cases of M. fortuitum bacteremia in patients with cancer, one of whom was neutropenic, are presented. None of the patients had evidence of disseminated disease or endocarditis, and there was no mortality directly associated with this infection. Two patients had polymicrobial sepsis with skin commensal organisms. The infection was related to the use of long-term central venous catheters or recent instrumentation in all patients. M. fortuitum should be added to the growing list of organisms causing catheter-related infections.
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PMID:Mycobacterium fortuitum bacteremia in patients with cancer and long-term venous catheters. 361 25


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