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 total of 209 consecutive neonate and infant autopsies were reviewed with special attention to papillary muscle necrosis (PMN) of the heart. Associated major pathological findings were analysed for the evaluation of significant pathological accompaniments of PMN. PMN was found in 52 cases among 171(30.4%) neonates and major pathological accompaniments were bronchopneumonia, hyaline membrane disease, hypoxic neuronal change, sepsis, subarachnoid hemorrhage, disseminated intravascular coagulation (DIC) and acute tubular necrosis, among which hypoxic neuronal change and ATN had a statistically significant higher incidence when compared with the control group. (p < 0.005). PMN was found in 13 cases among 38(34.2%) infants and accompaniments were congenital heart disease, sepsis, bronchopneumonia, DIC and hypoxic neuronal change, all of which showed no difference from the control group in incidence. The results imply that PMN is a kind of organ damage in stressed subjects regardless of age, that it is not a special form of myocardial injury in any specific age group including the newborn period, and is possibly of different pathogenesis and significance.
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PMID:Papillary muscle necrosis in neonates and infants--analysis of 209 autopsies. 129 38

To study the incidence and types of infection among severely traumatized children, we reviewed the medical charts of 212 children, hospitalized following traumatic injury, who received antibiotics at sometime during their hospitalization. Infection occurred in 19%. Eleven children had trauma-related infections, whereas 29 (71% of those infected) had 36 nosocomial infections. Tracheitis, sepsis, and urinary tract infections were the most common nosocomial infections and were diagnosed in the second week (10 +/- 3 days) following injury. Nosocomial infections were more likely to develop in children who were more severely injured and who had a greater number of invasive procedures. Severe head injury (cerebral edema or subarachnoid hemorrhage) was more common in those with nosocomial infection (P < .0002, odds ratio 6.8, 95% confidence interval 2.2 to 21.3). Those without these injuries were much less likely to develop nosocomial infections (specificity 97% and negative predictive value 86%). Finally, the development of any nosocomial infection prolonged the hospitalization by a mean of 16 +/- 6 days when comparing children with the same degree of traumatic injury. Prevention of nosocomial infection in children with severe trauma will significantly reduce length of hospitalization.
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PMID:Infections in severely traumatized children. 147 96

A 61-year-old female developed subarachnoid hemorrhage after trans-sphenoidal surgery for Rathke's cleft cyst. Neuroradiological examination revealed a large aneurysm at the C1 portion of the right internal carotid artery. Autopsy revealed marked proliferation of aspergillus hyphae in the wall of the aneurysm. A review of previously reported cases of fungal aneurysm proposes two developmental processes. Aneurysms secondary to fungal meningitis tend to be large in size and located in the major cerebral artery trunk, but aneurysms following fungal sepsis tend to be small and in peripheral branches. The former aneurysms are probably caused by fungus invasion into the intracranium, usually from the paranasal sinus, and the latter may be due to fungal emboli like bacterial emboli in bacterial endocarditis. Ruptured fungal aneurysms are difficult to treat, so fungal meningitis or sepsis must be eradicated before an aneurysm develops.
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PMID:Aspergillus mycotic aneurysm--case report. 172

We present a 28-year-old-patient with a severe head injury: skull fractures, epidural hematoma, subarachnoid hemorrhage, Glasgow coma score 7, and aspiration following a motorbike accident. A systemic infection with symptoms of shock and Staphylococcus aureus in blood culture specimens developed a few days after admission (later Staphylococcus epidermidis was also cultured). A posttraumatic hydrocephalus was treated by a ventriculo-peritoneal shunt inserted at mini-laparotomy. In multiple microbiological and cytological tests the cerebrospinal fluid (CSF) was always sterile. Enterocolitis occurred with Clostridium difficile and Staphylococcus aureus in stool cultures. After 6 months' intractable sepsis the patient died with multiple-system failure. Autopsy revealed secondary displacement of the shunt catheter into the intestinal lumen. A possible ascending infection was found in the form of a cerebral ventricular empyema. However, prior to death there was no specific clinical sign of peritonitis or encephalitis or a positive microbiological or cytological CSF findings. Despite insertion of a ventriculo-peritoneal shunt under visual control, this case shows that secondary displacement of the peritoneal extremity into the bowel can occur, which may cause a cerebral and eventually a systemic infection. CSF examinations may fail to show contamination; specific clinical signs may be absent or, with multiple-system failure, misleading. An autopsy is generally to be recommended as it contributes to a better understanding of the clinical problems in most cases.
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PMID:[Secondary penetration of a ventriculo-peritoneal shunt into the intestines. Possible cause of a recurring sepsis?]. 188 61

The sonograms of 12 infants aged 2 days to 7 months were evaluated to determine if the torcular Herophili could be demonstrated routinely on cranial sonography. Sonography, which was performed for a variety of indications (prematurity, seizures, hydrocephalus, sepsis, congenital anomalies, and subarachnoid hemorrhage) demonstrated the torcular Herophili in all cases. It appeared as a variable-sized, anechoic, and triangular or elongated structure inferior to the occipital lobes, posterior to the cerebellum, and just inside the cranial vault. Correlation with computed tomographic scans was available in four patients. A detailed description of the normal anatomy of the torcular Herophili is provided. Knowledge of the variable sonographic appearance of the torcular Herophili is important to distinguish it from a pathologic entity.
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PMID:Sonographic appearance of the torcular Herophili. 351 38

We report A series of 20 consecutive patients with 21 saccular aneurysms of the proximal (M1) segment of the middle cerebral artery. The incidence of M1 aneurysms was 3.0% among 660 patients with intracranial aneurysms and 12.9% among 155 patients with middle cerebral artery aneurysms in our center. Of the 20 patients, 2 were men and 18 were women. The aneurysms were classified into two types: the superior wall type (9 cases), arising at the origin of the lenticulostriate or fronto-orbital artery, and the inferior wall type (12 cases), arising at the origin of the early temporal branches. Twelve (60%) patients had ruptured M1 aneurysms. The incidence of multiple aneurysms was high (nine patients, 45%), and M1 aneurysms were responsible for subarachnoid hemorrhage in four patients. Of 14 M1 aneurysms greater than 5 mm in diameter, 11 (78.6%) ruptured. In contrast, only one (14.3%) of seven small (< or = 5 mm) aneurysms ruptured. In 12 patients with ruptured M1 aneurysms, intracerebral hematomas were recognized in 6 (50%). Intracerebral hematomas by the superior wall M1 aneurysms were located in the frontal lobe, and those by the inferior wall M1 aneurysms were in the temporal lobe. Fifteen patients (75%) made a useful recovery 6 months after surgery. Four patients (20%), who were in poor grade condition preoperatively, remained severely disabled. One patient died of sepsis 2 months after she recovered well from the operation. Special attention to the lenticulostriate arteries to avoid injury is critical for successful surgical treatment.
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PMID:Saccular aneurysms of the proximal (M1) segment of the middle cerebral artery. 775 43

The treatment of subarachnoid haemorrhage caused by aneurysm in comatose patients with or without midbrain symptoms is a matter of controversy. The question is, which comatose patients will profit from aneurysm surgery and which will not? In a retrospective study, 573 patients were examined between 1986 and 1992. Of these, 116 were in poor condition (Hunt and Hess Grade IV or V). The following management protocol was used: after computer tomography, a decision was made whether intensive medical treatment was performed or not. The reason for not operating was essentially the severity of the cerebral haemorrhage and poor or absent intracranial filling on angiography. Extracerebral causes were renal failure, sepsis, liver cirrhosis and pulmonary embolism. The direct early aneurysm operation was performed in the clinical deterioration phase in patients with space-occupying haematomas. In dilatation of the ventricle system, external drainage was initially positioned, in the case of bilateral haematocephalus, two-sided drainage was positioned, then intensive medical treatment and angiography were performed. The aneurysm operation was then ruled out if there was no clinical improvement. Aneurysm operation was performed on 57 of the 116 patients; 13 died, 32 showed a good and 12 a poor or fair outcome. 15 patients had mid-brain syndrome, and 5 of them died. Based on our experience, we draw the following conclusion: the Hunt and Hess scale alone is not a sufficient basis for decision taking. Some of the comatose patients, even in mid-brain syndrome, profit from an early operation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Modulated surgery in the management of ruptured intracranial aneurysm in poor grade patients. 791 32

This manuscript reports Bacillus cereus sepsis in two cases with acute myelogenous leukemia (AML) who suffered complications of fatal intracranial hemorrhage during remission induction therapy. The first case was 43-year-old male with AML (M0) receiving first consolidation chemotherapy who developed sudden diarrhea, abdominal pain and spiking fever. Two days later, he died of intracranial hemorrhage. The second case was 15-year-old male with AML (M5b) who was receiving first induction chemotherapy. He developed headache and vomiting following spiking fever and diarrhea. He died of subarachnoid hemorrhage the next day. In both cases, Bacillus cereus was isolated from blood culture. Fatal intracranial hemorrhage due to severe bleeding tendency caused rapid to death in both cases. These bleeding tendencies might have been induced by B. cereus sepsis. In addition, we should not overlook B. cereus as contamination, but rather consider it as a potential pathogen, when isolated from blood culture.
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PMID:[Two cases of acute myelogenous leukemia with Bacillus cereus bacteremia resulting in fatal intracranial hemorrhage]. 829 31

Invasive hemodynamic monitoring has become standard in the management of aneurysmal subarachnoid hemorrhage. This study is a retrospective analysis of 630 Swan-Ganz catheters placed in 184 patients with aneurysmal subarachnoid hemorrhage. Evaluation of complications demonstrated a 13% incidence of catheter-related sepsis (81 of 630 catheters), a 2% incidence of congestive heart failure (13 of 630 catheters), a 1.3% incidence of subclavian vein thrombosis (8 of 630 catheters), a 1% incidence of pneumothorax (6 of 630 catheters), and a 0% incidence of pulmonary artery rupture. In the management of patients with aneurysmal subarachnoid hemorrhage, invasive hemodynamic monitoring continues to be an important tool with acceptable complications.
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PMID:Complications of Swan-Ganz catheterization for hemodynamic monitoring in patients with subarachnoid hemorrhage. 855 34

This study was conducted to determine the timing of intracranial hemorrhage (ICH) in patients on extracorporeal life support (ECLS) to improve the use of the head ultrasound in the detection of ICH. A review was conducted of all neonatal ECLS patients at the neonatal intensive care nursery at Kosair Children's Hospital in Louisville, Kentucky, from May, 1985 through November, 1994 to establish a study group of infants in whom an ICH developed while on ECLS. Thirty infants who had an ICH (excluding subarachnoid hemorrhage and infarction) on ECLS were included in the study. Data were collected that included patients demographics, age at initiation of ECLS, duration of ECLS, type of ECLS support (venoarterial or venovenous), oxygenation index and last arterial blood gas before ECLS, hours of ECLS before ICH, and grade of ICH. ICH occurred in 9.9% of the neonatal patients requiring ECLS. These included 8 infants with a Grade I bleed, 1 infant with a Grade II, 4 infants with a Grade III, and 17 infants with a Grade IV. Ten of the 30 patients had sepsis as their primary diagnosis, and these infants were more likely to have an ICH while on ECLS compared to nonseptic infants (p < 0.02). The Kaplan-Meier curve showed that 50% of ICHs occurred in the first 24 hours of ECLS, 75% by 48 hours, and that 85% of ICHs occurred within 72 hours of initiation of bypass. There was no difference in timing of ICH in the septic infants compared to the nonseptic infants. The late occurring bleeds (> 72 hours) were all associated with significant neurologic changes or with multiorgan failure. It is concluded that daily head ultrasounds should be performed during the first 3 days of ECLS because most ICHs (85%) occur in the first 72 hours of cardiopulmonary bypass. In this era of cost containment, subsequent head ultrasounds should be obtained with changes in the infant's neurologic status or with the development of multiorgan failure.
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PMID:Timing of intracranial hemorrhage during extracorporeal life support. 895 65


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