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)

We report a 65-year-old Japanese woman with Kaposi's sarcoma (KS). The eruption first occurred on the legs while she was admitted for treatment of poorly differentiated lung cancer. Approximately eight months after the evolution, cutaneous tumors rapidly spread to the forearms, trunk, and pharynx. At that time, the patient had received systemic corticosteroid (10-40 mg/day of prednisolone) for about three months to reduce pulmonary inflammation. The laboratory data showed anemia, lymphopenia, hypogammaglobulinemia, and a decreased T cell count, although the serological test for HIV infection was negative. The patient was treated with radiation (X-ray for KS of pharynx and electron beam for KS of lower legs) and local intralesional injection of vinblastine. Although both therapies were very effective and well tolerated, she died of bacterial pneumonia and sepsis. Autopsy revealed KS tumors, unknown before death, in both lungs, the esophagus, and the stomach. The left lung cancer had disseminated and metastasized to the right lung, pleura, mediastinum, and abdominal cavity. It is suspected that chronic respiratory distress and systemic use of corticosteroids might have induced the rapid extension of KS.
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PMID:Kaposi's sarcoma associated with lung cancer and immunosuppression. 885 91

To examine intensive care unit (ICU) admission rates and diagnoses of patients with HIV infection, and to determine the outcomes of different critical illnesses, we analyzed data derived from the 63 patients who were admitted to an ICU from among the 1,130 adults with HIV infection who did not have AIDS at the time of enrollment in a multicenter prospective study. Patients were admitted and treated according to the judgment of their physicians. During 4,298 patient-years of follow-up for the entire cohort, there were 1,320 hospital admissions, of which 68 (5%) included admission to an ICU. Twenty-five (40%) of the patients admitted to the ICU died during that admission. Twenty-four patients (38%) were admitted with a principal diagnosis of lung disease; 11 had Pneumocystis carinii pneumonia (PCP), one of whom was coinfected with Aspergillus fumigatus and Legionella pneumophilia, and six of them (55%) died. Four had bacterial pneumonia, two had pulmonary edema caused by renal failure, and one each had pulmonary tuberculosis, pulmonary Kaposi's sarcoma, pneumothorax, adult respiratory distress syndrome, severe pulmonary fibrosis, cytomegalovirus pneumonitis, and metastatic adenocarcinoma to the lungs. Eleven of these 14 patients (79%) died. Thirty-nine patients had 44 admissions for nonpulmonary diagnoses, including gastrointestinal disorders (14 admissions), cardiovascular disorders (nine), sepsis syndrome (six), neurologic disorders (four), monitoring and ICU nursing care during or after a procedure (four), metabolic disorders (three), trauma (two), drug overdose (one), and unknown reasons (one). Nine (23%) of these patients died. Twenty-eight patients underwent mechanical ventilation, and 16 (57%) died. Seven (25%) had PCP (five died), seven had other primary pulmonary diseases (six died), and 14 were placed on mechanical ventilation for nonpulmonary disorders (five died). Survival did not correlate with CD4 count determined within 6 mo of admission to the ICU. In conclusion, the range of indications for critical care in patients with HIV infection is diverse. PCP accounted for only 16% of the ICU admissions, and mechanical ventilation for PCP and other pulmonary disorders was associated with a high mortality rate. In contrast, mechanical ventilation for nonpulmonary disorders, and admission to the ICU for nonpulmonary diagnoses was associated with a more favorable outcome.
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PMID:Intensive care of patients with HIV infection: utilization, critical illnesses, and outcomes. Pulmonary Complications of HIV Infection Study Group. 900 Dec 91

We describe Kaposi's sarcoma accompanied by osteomyelitis of the gum, cystic degeneration of the kidneys and E. coli sepsis in an Alsatian with very severe acquired immunodeficiency stimulated by poisoning with organophosphates. This is the first case of Kaposi's sarcoma observed in animals.
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PMID:Kaposi's sarcoma in dog with acquired immunodeficiency after phosphate poisoning. 982 22

Several pathogenetic processes are involved in the progression to AIDS in HIV-infected individuals. These include a gradual, but ultimately profound, depletion in CD4 lymphocytes, defects in B lymphocytes, neutrophil dysfunction and the breakdown of the integument as a consequence of AIDS-related dermatological conditions such as bacterial and fungal dermatoses and Kaposi's sarcoma. Each of these factors has important implications regarding host susceptibility to nosocomial infections. This review deals with some of the difficulties that are encountered in precisely defining the interrelationships between HIV infection/AIDS and nosocomial sepsis, and some of the controversies that surround respiratory, bloodstream (including central venous catheter-related infections) and gastrointestinal infections that may be acquired within healthcare centres. Because of the lack of accurate, detailed information on this subject, parallels will sometimes be drawn from observations made in other immunologically impaired patient groups and from data examining the rates of community-acquired infections in HIV-infected patients compared to controls. Appropriate and rational infection practice to minimize the risk of acquisition of nosocomial infection is highlighted. Finally, some of the common methodological problems commonly encountered in the current literature regarding nosocomial infections in this population group, and future challenges in the study of these infections, are reviewed.
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PMID:Nosocomial infections in HIV-infected/AIDS patients. 1065 79

To evaluate the etiology and differential features of intrathoracic lymphadenopathy (LAD) in HIV patients, chest computed tomography (CT) records from an 18-month period were reviewed to identify all HIV-positive patients with intrathoracic LAD (nodal size > or = 1 cm). Medical records were reviewed for the documentation of specific diseases causing LAD and the CD4 count at the time of imaging. Of 45 HIV-positive patients with LAD, 40 had specific diagnoses including 22 (55%) infections and 17 (43%) tumors; one patient had both (3%). Mycobacterial disease accounted for 78% of infections; five cases were secondary to bacterial pneumonia and sepsis. Of tumors, lymphoma (7 cases, 39%) was most common, followed by lung cancer, germ cell tumors, and Kaposi's sarcoma. Mean CD4 cell count in patients with tumors was much higher than in patients with infections (314 vs. 62, p < .01). Patients with tumors were somewhat more likely than patients with infections to demonstrate axillary adenopathy (29 vs. 5%, p = .068). Cavitary disease was only observed in patients with infections (27%, p < .03). CT and clinical findings may help direct the differential diagnosis of LAD in AIDS, and promote expedient definitive diagnosis and therapy.
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PMID:Thoracic lymphadenopathy in HIV patients: spectrum of disease and differential diagnosis. 1074 9

Our objective was to describe clinical features and predisposing factors attributed to lactic acidosis in 4 HIV-infected patients on long-term nucleoside reverse transcriptase inhibitor (NRTI) therapy. All patients had received at least 6-20 months of NRTI-containing antiretroviral therapy: all used stavudine (d4T), in one combined with lamivudine (3TC), in the other 3 with didanosine (ddI); in one hydroxyurea was added. In all, the initial symptoms were gastrointestinal (nausea and vomiting), followed by tachypnoea preceding the lactic acidosis; death followed 6-22 days after admission (liver failure and uncontrollable arrhythmias). Treatment with riboflavin was unsuccessful in one patient. The only definite risk factor in all cases was NRTI-induced mitochondrial toxicity; one patient was concomitantly treated for Kaposi's sarcoma (with bleomycin and vinblastine) and one just recovered from pneumococcal sepsis. None of the patients had a history of chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. In all patients, some sort of toxicity to other previously used NRTIs had occurred earlier. Lactic acidosis occurred after months of NRTI therapy in patients who had already suffered other forms of NRTI toxicity. Concomitant diseases or comedication might have aggravated the mitochondrial toxicity of the NRTIs. Screening methods to detect mitochondrial toxicity are necessary, since lactic acidosis occurs rather unexpectedly, with a rapid, fatal course.
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PMID:Clinical features and risk factors of lactic acidosis following long-term antiretroviral therapy: 4 fatal cases. 1099 8

Opportunistic infections (OIs) continue to be a leading cause of death in persons with AIDS, and have been found to be more prevalent in some populations than others. Researchers investigated which OIs occured most among three categories of HIV transmission: homosexual and bisexual men, intravenous drug users, and female partners. Death from cytomegalovirus (CMV), toxoplasmosis, and Kaposi's sarcoma occurs in homosexual and bisexual groups. Women have a much higher risk of bacterial pneumonia and bacterial sepsis. Injection drug users suffer greater risks of bacterial pneumonia and non-HIV related causes such as liver damage, heart attack, suicide and drug overdose. Female drug users had the poorest prognosis of any group studied, due to lower income and educational levels, and less healthy lifestyles.
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PMID:Death waits for no man, but OIs do. 1136 84

The clinical course of HIV seropositive renal allograft recipients is ill defined. Thus, a retrospective analysis of mortality, morbidity and graft survival was performed in two groups of HIV-positive patients. Group 1 (nine patients), seropositive for an indefinite period of time prior to transplantation (eight i.v. drug abusers, one homosexual), all lost their grafts after a mean period of 23 +/- 11 months from chronic rejection (six), complicated by focal glomerular sclerosis and nephrotic syndrome in three cases, sepsis (two) and death with a functioning graft (one). Four patients died, two from sepsis, one from Kaposi's sarcoma and one from fluid overload. Of the remaining five patients, all on hemodialysis, one had AIDS and four were asymptomatic after a mean period of 44 months following graft failure. Prolonged hospitalizations for both infections and acute rejection were common. Group 2 (six patients) seroconverted in the perioperative period, and two had functioning allografts at 78 and 100 months post-transplant. Causes of allograft loss, patient death and infection-related complications were similar to those of group 1, but acute rejection was rare. In conclusion, HIV infection in renal allograft recipients was associated with poor allograft survival due mainly to rejection, mostly chronic, often complicated by glomerular sclerosis and nephrotic syndrome. Infectious complications requiring hospitalization were also increased.
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PMID:The course of HIV disease in renal allograft recipients. 1462 55

Kaposi's sarcoma (KS) usually presents with typical skin lesions. We report two cases that presented with illnesses suggesting major sepsis, but were found to have disseminated KS at postmortem with little in the way of cutaneous involvement.
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PMID:Septic illness and Kaposi's sarcoma. 1800 17

Wounds are a hallmark of various skin diseases. Most patients with wounds suffer from chronic venous insufficiency or other vascular diseases. Autoimmune, infective, metabolic, malignant, some psychiatric and diseases caused by environmental factors like radiation, present with skin and mucosal erosions and ulcerations. Lichen planus, lichen sclerosus, toxic epidermal necrolysis, Kaposi sarcoma, genodermatoses like Hailey-Hailey and Darier's disease belong to different dermatological entities, they have different etiology, pathogenesis and clinical presentation, but at some stage ulcerations and erosions dominate through the disease course as a result of complications of untreated disease or as part of a complex clinical presentation. Wounds demand a different multidisciplinary therapeutic approach, sometimes even in intensive care unit, where special care is available. Most patients are followed-up to avoid fatal complications like sepsis, as well as a potential malignant transformation of cells in the environment of chronic inflammation. Wounds are found in female genital lichen planus and lichen sclerosus. Oral lichen planus has a potential for malignant transformation and is considered a precancerous disease. Toxic epidermal necrolysis is a life threatening disease similar to burns. Wounds cover most of the body surface as well as mucosa. The high mortality rate is due to complications like sepsis, loss of thermoregulation, electrolyte and fluid disbalance and shock. Chronic wounds are also a hallmark of skin tumors and other skin malignancies like Kaposi sarcoma and lymphoma. The primary treatment goal in genodermatoses like epidermolysis bullosa is wound care, and to a less extent in other inherited skin diseases like Hailey-Hailey and Darier's disease wound healing is important for sustaining a good quality of life in affected individuals.
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PMID:[Wounds and dermatoses]. 2319 18


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