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 27-year old woman admitted to the hospital after 5 days of vaginal bleeding at 12 weeks gestation had had a copper-T IUD inserted 10 months previously. The IUD string was no longer visible at pregnancy testing. Prior to admission she had experienced lower abdominal pain, increasingly heavy vaginal bleeding, fever, malaise, chills, and vomiting. Intravenous ampicillin and metronidazole were commenced and the uterus was evacuated under a general anesthetic. The copper-T was removed from the uterine cavity. A uterine swab at operation and preoperative blood cultures grew E. coli. A moderate degree of disseminated intravascular coagulation (DIC) was indicated by a coagulation profile. The case demonstrates that the copper-T may be associated with intrauterine sepsis and DIC. In the 1st trimester the risk of abortion following removal of a device is near 30%, while the rate of abortion for women in whom the string is no longer visible is near 48%. Patients presenting with pregnancy in the presence of an IUD and symptoms of sepsis should have the uterus evacuated under suitable antibiotic cover.
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PMID:Septic abortion in an IUCD user. 676 7

Infections are still the most frequent peripartal complications. Very often they are nosocomial (hospital acquired) infections. Diagnosis and therapy of severe conditions may pose considerable problems. The most significant clinical factors in patient survival are the attentive surveillance and early recognition of the patient's disorder. The choice of antibiotics has to be done in consideration of the bacteriology of the vagina (endogenous infection). Removal of the infection site (uterus with or without adnexae) is the therapeutic procedure with the highest success rate in cases with sepsis or bacterial shock. Prophylaxis of infectious morbidity following caesarean section seems to be possible and advisable in patients with certain risk factors (labour, rupture of membranes, repeated vaginal examinations).
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PMID:[Peripartal infections]. 692 31

Previous reports have implicated the Dalkon shield intrauterine device (IUD) in septic second trimester abortion and maternal death from sepsis. In the case reported here, Fusobacterium necrophorum, a rarely pathogenic vaginal anaerobe, gained access to the uterus in a woman wearing a Dalkon shield and caused acute parametritis, overwhelming peritonitis, systemic sepsis, and death. It is well known that IUDs can contribute to the development of serious pelvic infections, and in this case it is possible that the Dalkon shield was the cause of the ascending infection into the uterus.
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PMID:Fatal peritonitis following IUD-associated salpingitis. 726 60

Ordinarily the IUD does not give rise to any unpleasant effects on the woman's organism. But the literature does contain references to peritonitis, sepsis, and even perforation of the uterus. The present case describes an IUD which passed through the uterine tube into the abdominal cavity. The patient, a 28-year old woman, had been fitted with an IUD and a month later came to the clinic with a serious case of nonspecific pneumonia. Soon after she died of cardio-pulmonary insufficiency. At autopsy, in the left uterine tube (in the ampulla) we discovered the IUD threads, while the IUD itself was hanging in the abdominal cavity. We could not find any macro- or micro-pathological changes in the uterus. The reasons might have been connected with the fact that the IUD was inserted 1 month after the woman had a stillbirth. The basic mechanism would be that the IUD was wedged into the isthmus of the uterine tube at the time of insertion and then compressed, thus facilitating its subsequent movement toward the abdominal cavity.
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PMID:[Rare complication of intrauterine contraception]. 728 93

In 2 case reports the radiologic diagnosis of pelvic abscess caused by a Dalkon Shield type IUD was demonstrated. In the 1st case the pelvic abscess was visualized as an impression on the anterior rectal wall and the displacement of the distal 1/3 of the sigmoid. This was confirmed at laparotomy when a Douglas abscess and an inflamed uterus was found. In the 2nd case a segmental narrowing of the rectum and distal 1/3 displacement of the sigmoid were radiographically demonstrated. The spontaneously draining sacrouterine abscess healed with conservative treatment. The Dalkon Shields were removed in both cases. Although the newer IUD's carry less risk of infection this risk is still considerable as reported in the literature. A 1978 review of 6 epidemiologic studies points to a 3 to 5-fold higher risk of pelvic infection with IUD use. This risk may be higher for women without previous pregnancy and may drop to a low of 1.7 in women with previous pregnancy. Some authors point to a higher risk of adnexitis with the Dalkon Shield compared to other types of IUDs. The Dalkon Shield has been removed from the market in the US and other countries after a US publication of 35 fatalities caused by sepsis in IUD users.
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PMID:[Radiologic demonstration of pelvic abscess associated with I.U.D. (Dalkon Shield) in two patients (author's transl)]. 732 15

The Safe Motherhood Initiative was launched in 1988 as a global effort to halve maternal mortality and morbidity by the year 2000. The program uses a combination of health and nonhealth strategies to emphasize the need for maternal health services, extend family planning services, and improve the status of women. The maternal mortality rate (per 100,000 live births) is 390 for the world, 20-30 for developed countries, 450 for developing countries, and 420 for Asia. This translates into 308,000 maternal deaths in Asia, of which 100,000 occur in India. The direct causes of maternal mortality include sepsis, hemorrhage, eclampsia, and ruptured uterus. Indirect causes occur when associated medical conditions, such as anemia and jaundice, are exacerbated by pregnancy. Underlying causes are ineffective health services, inadequate obstetric care, unregulated fertility, infections, illiteracy, early marriage, poverty, malnutrition, and ignorance. India's Child Survival and Safe Motherhood Program seeks to achieve immediate improvements by improving health care. Longterm improvements will occur as nutrition, income, education, and the status of women improve. Improvements in health care will occur in through the provision of 1) essential obstetric care for all women (which will be essentially designed for low-risk women), 2) early detection of complications during pregnancy and labor, and 3) emergency services. Services will be provided to pregnant women at their door by field staff, at a first referral hospital, perhaps at maternity villages where high risk cases can be housed in the latter part of their pregnancies, and through the continual accessibility of government vehicles. In addition, family planning services will be improved so that fertility regulation can have its expected beneficial effect on the maternal mortality rate. The professional health organizations in India will also play a vital role in the success of this effort to reduce maternal mortality.
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PMID:Strategies for safe motherhood. 765 34

Extra-amniotic injection of prostaglandin F2a has proved to be an effective method of termination of pregnancy, although its use has been associated with serious complications including rupture of the uterus and maternal death. In this retrospective study of 45 patients who required termination of pregnancy in Eshowe Hospital for intra-uterine death or missed abortion two patients developed minor complications of this method. Forty four patients aborted between four hours 30 minutes and 18 hours 15 minutes after the injection. There was one patient who had a failed induction and who developed serious sepsis. It is not clear whether the sepsis was a result of the method used to induce labour or whether it was the primary pathology causing the intra-uterine death and failed induction.
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PMID:Termination of pregnancy using extra-amniotic prostaglandin F2a--experience in a peripheral hospital. 781 97

A 78-year-old woman was admitted to our hospital because of disturbance of consciousness. She had been diagnosed as uterus carcinoma and had undergone radiotherapy one year before admission. On admission, her body temperature was 35.5 degrees C and systolic blood pressure was 50 mmHg. Ascites and semicomatose consciousness were detected. Laboratory evaluation demonstrated the following values: leukocyte count 38800/microliters, blood sugar 3 mg/l and arterial blood pH 6.9. Therapy with catecholamine and antibiotics was started, but she expired 10 hours after admission. Bacteroides ovatus was detected from her blood. Autopsy findings disclosed abscess and perforation of the uterus, and liver cirrhosis. Hypoglycemia has rarely been described as a clinical manifestation of sepsis and this case is, to our knowledge, is the first report of sepsis complicated with hypoglycemia in Japan.
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PMID:[A case report: sepsis associated with hypoglycemia]. 793 Jul 92

The results of laparoscopic appendectomy under outpatient conditions are reported here from a retrospective analysis of the data for 78 women (aged 17-55) selected as having clinically acute or subacute appendicitis. Patients with severe disease presenting with sepsis or peritonitis were excluded, since they were referred to hospital. The duration of the procedure in the 78 women was 30-120 minutes (mean: 45), and only one minor intraoperative complication (a slight lesion to the uterus from the working trocar) was encountered. Follow-up was carried out by daily telephone interviews and a physical examination on the third or fourth postoperative day. Five postoperative complications (four cases of peritonitis and one stump insufficiency) were found two to seven days after the laparoscopic appendectomy, and these had to be treated by laparotomy. No severe sequelae or mortality were encountered. The calculated costs of the laparoscopic approach (DM 1,000.00 in total for anesthesia and operation) compared favorably with a conventional inpatient regimen covering seven days (DM 3,000.00-5000.00). We conclude that laparoscopic appendectomy under outpatient conditions is a safe and cost-effective modality for treating acute and subacute appendicitis in selected patients.
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PMID:Results of outpatient laparoscopic appendectomy in women. 807 48

Intraamniotic instillation of urea is a common mode of legal second-trimester pregnancy termination. Associated mortality rarely occurs and is most commonly due to amniotic fluid embolism, pulmonary thromboembolism, infection, hemorrhage, and disseminated intravascular coagulation (DIC). We present the case of an 18-year-old gravida 2, para 1 white woman at 18 weeks' gestation who underwent intraamniotic instillation of hyperosmolar urea and intracervical insertion of laminaria tents; 19 h later, she became unresponsive, academic, and went into shock. Coagulation studies were diagnostic of DIC. Bacilli were seen on peripheral blood smear. Autopsy showed marked subcutaneous emphysema of the anterior abdominal wall, necrosis and emphysema of the uterus, diffuse pulmonary alveolar damage, and renal cortical necrosis. Antemortem blood cultures grew Clostridium perfringens and Escherichia coli. Postmortem culture of the uterus grew E. coli. The source of infection was most likely the introduction of vaginal organisms via laminaria insertion. This is apparently the first reported case of death caused by Clostridium perfringens and E. coli sepsis following urea instillation.
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PMID:Fatal Clostridium perfringens and Escherichia coli sepsis following urea-instillation abortion. 832 37


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