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

The authors report a case of Pasteurella multocida meningoencephalitis in a 5 week-old female infant, with special attention to clinical, laboratory and evolutive features. A moderate neurological sequel was observed at follow-up examinations. A brief review of the importance of P. multocida in human pathology is presented on the basis of the international literature, since the authors did not find any Brazilian reports. The most important feature on P. multocida is the prevalence of bacterial meningitis at the extremes of age. Otherwise, significant mistaken was found between Gram stained smears of body fluids for P. multocida and Haemophilus influenzae or Neisseria meningitidis. Because its role in infections following animal bite or scratch and its opportunistic feature, P. multocida must be included among the possible etiologic agent of bacteremia or sepsis in patients with liver cirrhosis or immunosuppression.
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PMID:[Meningoencephalitis due to Pasteurella multocida: clinico-laboratory study of a case in an infant]. 263 88

Bacteroides fragilis is an obligated anaerobic bacillus which forms part of the normal intestinal flora of the colon and is often seen as a common pathogen in intraabdominal infections. It is an infrequent pathogen in cases of meningitis; a review of the literature reports only eight cases of this disease in children, especially in neonates with conditioning factors such as abdominal sepsis, chronic middle ear otitis and atrial-ventricular derivations. A case of a newborn baby girl with lumbosacral myelomeningocele is reported. After the defect was surgically corrected, the wound became infected, the stitches opened, the child began to have fever, became irritable and suffered convulsions. The spinal tap showed changes compatible to bacterial meningitis, the bacteria was grown on Shaedler medium. The child was treated with cefotaxime and amikacin showing no satisfactory improvement. Afterwards, a second spinal tap showed Bacteroides fragilis.
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PMID:[Meningitis caused by Bacteroides fragilis in children]. 269 35

Twenty-seven newborns had an episode of late-onset sepsis (septicaemia or bacterial meningitis after 48 h of age) over an 18 month period. Preceding or simultaneous surface cultures were available from 26 babies. Colonization with the organism causing sepsis could only be documented in 10 cases. Colonization with aminoglycoside-resistant Gram negative organisms was common but there were only two cases of systemic sepsis with a resistant organism. Pseudomonas aeruginosa frequently colonized babies over the first 8 months of the survey, but subsequently virtually ceased to colonize babies, although it continued to be a common cause of late-onset sepsis. These findings do not support the utility of routine surveillance of organisms colonizing neonates in predicting bacteria causing late-onset sepsis. They also cast doubt on the value of eliminating colonizing organisms by expensive infection control measures.
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PMID:Surveillance of colonization and late-onset septicaemia in neonates. 288 63

We evaluated fever in 342 hospitalized infants less than 8 weeks of age. Sixteen infants (5%) had bacteremia or bacterial meningitis. Fifty-two percent of the infants were admitted during the months of July through September. We found no significant relationship between season, sex, height of fever, or erythrocyte sedimentation rate and the recovery of bacteria from the blood or CSF. A WBC less than or equal to 5,000/cu mm or a ratio of immature to total neutrophils greater than or equal to 20% correlated significantly with bacteremia or bacterial meningitis, though the sensitivities of these tests were unacceptably low. Prospectively, of 61 infants whose clinical appearance did not suggest sepsis, none had bacterial pathogens in the blood or CSF, whereas four of 36 infants with a septic appearance did have pathogens. Recent investigations support the initial clinical impression as important in assessing these febrile infants. We found that bacteremia is more likely to occur in infants less than 4 weeks of age (8%) than in the older infants (2.9%).
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PMID:Evaluation of fever in infants less than 8 weeks old. 330 62

Bacteroides fragilis is a rare cause of bacterial meningitis. In the antibiotic era nine cases have been reported. Seven of these nine cases occurred in premature infants and neonates. Of the nine patients with B. fragilis meningitis, two died, four survived with neurologic sequelae, and three survived without sequelae. Predisposing conditions included abdominal sepsis, chronic otitis media, and ventriculoatrial shunt infection. Metronidazole, which is bactericidal, has been the most effective therapy for B. fragilis meningitis.
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PMID:Bacteroides fragilis meningitis. 233 Apr 83

Nine patients with suspected gram-negative bacterial sepsis were studied to determine the safety, pharmacokinetics, and immunogenicity of XMMEN-0E5, a murine immunoglobulin M monoclonal antibody directed against the core lipid A region of bacterial endotoxin. Antibody was administered by single intravenous infusion of 1 to 4 h duration at doses ranging from 0.1 to 15 mg/kg. Five patients had positive blood cultures for gram-negative bacteria, one patient had Torulopsis septicemia, one patient had gram-negative bacterial meningitis, and two patients were culture negative. No evidence of antibody-mediated toxicity was observed at any dose level. The serum half-life of the antibody was approximately 10 h at doses of 0.1 to 7.5 mg/kg and approximately 18 h at a dose of 15 mg/kg. No apparent difference in clearance of antibody was observed between bacteremic and nonbacteremic patients. Human anti-mouse antibodies were detected in the sera of three evaluable patients that received doses equal to or greater than 2.0 mg/kg but not in patients that received lower doses of antibody. This study demonstrates that XMMEN-0E5 is well tolerated at doses from 0.1 to 15 mg/kg and may be immunogenic at doses of 2.0 mg/kg and above. Controlled trials to establish the efficacy of this antibody in the treatment of gram-negative bacteremia are indicated.
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PMID:Phase I study of a murine monoclonal anti-lipid A antibody in bacteremic and nonbacteremic patients. 339 1

Cerebrospinal fluid measurements of lactoferrin and alpha-1-antitrypsin showed significant elevation in bacterial meningitis in children. 8 of 10 lactoferrin values and 6 of 11 alpha-1-antitrypsin values were above the upper range of controls. Both proteins correlated well with the total number of leukocytes in the cerebrospinal fluid. C-reactive protein, measured by either agglutination or radial immunodiffusion in the cerebrospinal fluid, failed to demonstrate any usefulness in diagnosing bacterial meningitis. Neither elevated serum C-reactive protein in cases of bacterial meningitis, nor sepsis, gave detectable concentrations of C-reactive protein in the cerebrospinal fluid.
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PMID:Lactoferrin, C-reactive protein, alpha-1-antitrypsin and immunoglobulin GA in cerebrospinal fluid in meningitis. 348 45

The authors studied in the Paediatric Department of the Leverkusen Municipal Hospital retrospectively the influence of an early dose of antibiotics (broad-spectrum penicillin combined with an aminoglycoside) in respect of the manifestation of bacterial newborn infections in infants with an increased risk of infection, during a period of 3 years (1981-1983). Among the infants born in the Gynaecological Department of the Leverkusen Municipal Hospital (exact data were available on the number of births and referrals) the incidence of bacterial newborn infections was 3.3% referred to the total number of deliveries (n = 3598); 0.7% of these newborn has sepsis. In the total group of children treated for newborn infection, the infection mortality was 5.5%; the mortality of the manifest newborn sepsis was 16.2%, i.e. lower than reported in literature. Early administration of antibiotics proved particularly effective in preventing purulent bacterial meningitis of newborn; this disease did not occur with any of the infants observed during the study period. Diagnosis of newborn infection included discolouration of the skin, respiratory disturbances, fever, shift to the left in the differential blood picture, and anaemia; these signs proved particularly suitable for arriving at a correct diagnosis. Identification of the pathogens was most frequently successful in gastric juice culture and anal smear. The latency period of more than 24 hours between rupture of the amnion and delivery does not represent an increased risk of infection for the newborn, as our results confirm, and this is, therefore, not an indication for initiating prophylaxis with antibiotics if there are no other abnormal findings.
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PMID:[Neonatal septicemia and bacterial neonatal infection. Manifestation and course in early antibiotic therapy]. 395 62

In a 9-month prospective study conducted in an urban emergency room, 15 children with rectal temperature greater than 41.1 degrees C (106 degrees F) were evaluated. Seven of the 15 patients were admitted to the hospital. Two children who were discharged home required subsequent admission, and six were managed on an ambulatory basis. Eight (53.3%) children had serious disease: two bacterial meningitis, two bacteremia without meningitis, two pneumonia, one pericarditis with effusion, and one Kawasaki disease. In four, the final diagnosis indicated a much more serious illness than was considered initially. The laboratory studies did not correlate reliably with the final diagnosis or need for admission. Children with a rectal temperature greater than 41.1 degrees C are at high risk for a life-threatening illness and should be evaluated for sepsis and meningitis.
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PMID:Association of temperature greater than 41.1 degrees C (106 degrees F) with serious illness. 396 27

Six common clinical situations in infants and children are discussed from the point of view of standard therapeutic regimens: neonatal sepsis and meningitis; febrile episodes in neutropenia; bacterial meningitis; acute pulmonary exacerbations of cystic fibrosis; pneumonia, bone and joint infections, and cellulitis in patients less than four years of age; and intra-abdominal sepsis. Potential or actual problems with these therapeutic regimens and newer therapeutic options are outlined.
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PMID:Current needs for new beta-lactam antibiotics in pediatrics. 407 87


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