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

Forty-two patients were treated with intravenous cefoxitin, a new cephamycin antibiotic. These patients had postoperative abdominal sepsis (26), intrathoracic infections (6), urinary tract infections (5), gram-negative bacterial meningitis (2), septic arthritis (1), epidural abscess (1) and isolated septicemia (1). The antibacterial spectrum of cefoxitin was found to be one which included all gram-positive organisms except enterococci, most gram-negative organisms except Pseudomonas aeruginosa, and almost all of the important anaerobic organisms. The only five treatment failures included one patient with empyema and one with septic arthritis, both caused by Serratia marcescens, initially only moderately susceptible to cefoxitin, which subsequently developed increased resistance, two patients with contaminated intravenous catheters, and one patient with epidural abscess and cerebritis, who was treated late in the course. There was one serious clinical superinfection with P. aeruginosa. The drug levels noted in the pus and joint fluid were half to two-thirds of the simultaneous serum level. In inflamed meninges, up to 30% of the serum level was noted in the cerebrospinal fluid, and as the process resolved, 10 to 15% was noted. Toxicity of cefoxitin was mild and constituted skin rash in three patients (7%) and phlebitis in eight (19%).
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PMID:Use of cefoxitin, new cephalosporin-like antibiotic, in the treatment of aerobic and anaerobic infections. 74 74

Because of declining function of their immunologic and other organ systems, elderly individuals are more susceptible to certain types of infections of their heart valves, meninges, urinary tract, and skin. They may develop serious sepsis with subtle clinical signs and symptoms, which makes accurate diagnosis difficult. The antimicrobial agents of choice for use against the organisms most commonly responsible for these septic symdromes are listed in Tables 2, 3, and 4. Some methods of preventing these infections are discussed, but further studies to verify old techniques and establish new ones are needed.
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PMID:Host factors and infectious diseases in the elderly. 79 48

We have reviewed 107 cases of staphylococcal bacteraemia in order to assess the current clinical spectrum of serious staphylococcal sepsis in Zimbabwe, where staphylococcal bacteraemia is common. Infection was hospital-acquired in 35 cases and community-acquired in 72 cases. The mortality rate was 28%. Most patients were young, with predisposing conditions such as prematurity, protein-caloric malnutrition and measles. The length of the prodromal illness tended to be short and a primary site of infection, usually the lungs or skin, was obvious in 66% of patients. In 30% there was evidence of metastatic spread, usually to meninges, bone, joint and muscle, but endocarditis was uncommon. Metastatic infection was rare when infection was acquired in hospital. Death appeared to be associated with measles, protein-caloric malnutrition, acquisition of infection in hospital, absence of an obvious focus of infection and with inappropriate antibiotic therapy. Aggressive treatment with antibiotics intravenously was the rule. A combination of penicillin and an aminoglycoside was favoured until the nature of the infecting organism was established. Of those patients who died, 38% had received less than 72 h antibiotic therapy. Multiple antibiotic resistance is now widespread in Zimbabwe.
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PMID:Staphylococcal bacteraemia in Zimbabwe 1983. 403 14

Bacterial infections are frequent events in premature and newborn infants. The reason is a defective specific and nonspecific defence of bacterial organisms. Some immunoglobulins like IgM and IgA including secretory IgA are absent. Premature infants also show a decreased level of IgG. Cellular immunity is anatomically intact but functionally defective. A number of complement factors are lacking, the activation of the alternative pathway is impaired. Newborn infants with perinatal problems like asphyxia or difficult delivery, show defects of leucocyte function like decreased deformability, defective chemotaxis and defective killing of ingested bacteria. Certain diseases, like hypoxia and malformations of immature organ functions in this age group (decreased acid production in the stomach), facilitate bacterial colonization of surface epithelia and the invasion of tissues. Consequences of these pathogenetic mechanisms are an unimpaired propagation of bacterial organisms into the blood and meninges without localization of the infecting organisms at the entry site. Bacterial meningitis is not considered a separate disease entity but a complication of bacteremia and sepsis. Clinical symptoms are nonspecific at the onset of the infection. Fever is frequently absent; decreased appetite, vomiting, a bloated abdomen, diarrhea, tachycardia, tachypnea are early signs of a bacterial infection, a grey mottled appearance, cyanosis, jaundice, petechiae, apneic spells, seizure activity and a metabolic acidosis are symptoms of advanced infection. Successful treatment at this stage is often not possible. Every sign of a decreased well being of a newborn of premature infant warrants laboratory and bacteriologic work up for septicemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Chemotherapy of severe bacterial infections in pediatrics]. 631 69

Cefsulodin (CFS) was evaluated for its safety and efficacy in 14 children with Pseudomonas aeruginosa infections. The diagnoses included pneumonia (4), sepsis (1), presumed sepsis (4), acute postoperative ascending cholangitis (1), acute postoperative peritonitis with wandering pneumonia (1), acute enterocolitis with acute UTI (1), recurrent UTI (1), and acute cystitis (1). CFS was administered intravenously with a daily dose of 93 to 299 mg/kg in the cases with normal renal functions. CFS was effective in all but one case both clinically and bacteriologically. A case of pneumonia whose isolate was resistant to CFS responded poorly. Mild transient eosinophilia was observed in 3 cases, but no severe adverse reactions were encountered. Peak MIC values of 18 clinical isolates of P. aeruginosa were 1.56 mcg/ml, 0.39 to 0.78 mcg/ml and 12.5 mcg/ml for CFS, gentamicin, and sulbenicillin, respectively. A half life of the serum CFS levels was 1.09 hours after intravenous bolus injection of 20 to 25 mg/kg of CFS (n = 2). A cerebrospinal-fluid level and biliary levels measured in cases with inflamed meninges or with cholangitis were well above the MIC value. From the present study, CFS appeared to be a safe and effective antibiotic when used in children with susceptible Pseudomonas infections. Combined use of another antibiotic should be considered in the case with polymicrobial infections because of the CFS's very narrow spectrum.
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PMID:[Clinical evaluation of cefsulodin in Pseudomonas infections in children]. 716 64

The pathophysiological processes of the nervous system observed in the reactions to aggressive external stresses like severe trauma, systemic infection and so on have been reviewed. As is generally understood, such stresses as tissue destruction lead to the metabolic changes via proprioceptive impulses to central nervous system and neuroendocrinological courses. Cytokines are well known to work to induce systemic inflammatory responses and also to be important components of sepsis syndrome, for example. In the early phase of septic encephalopathy without overt infection of the brain or the meninges, it is possible that cytokines cause capillary leakage with brain edema, interference with microcirculation and direct effects on tissue metabolism resulting in brain dysfunction. And besides, Interleukins are prove to be produced in a few hours post-injury in experimental model. In clinical settings, severe head injury patients, who are often complicated with respiratory or urinary infection and with bacterial translocation, can suffer not only from systemic inflammatory responses originated from the brain but also from septic encephalopathy mentioned above. Therefore multiply traumatized patients with damaged brain for instance might well have to be considered as the aggregation, or integration of the systemic insult from the aspect of aggressology.
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PMID:[The significance of neurological manifestations from the aspect of aggressology]. 894 Jun 84

Five-day-old infant rats were injected intraperitoneally (i.p.) with anti-CD11b monoclonal antibody (1 B6) at a dose of 2 mg/kg or phosphate-buffered saline (PBS) either 1 h before or 3 or 24 h after inoculation with 10(5) cfu Haemophilus influenzae type b (Hib). When administered 1 h before infection, 23% of the 1B6- versus 17% of the PBS-treated rats and 87% of the 1B6- versus 83% of the PBS-treated animals died at 24 and 48 h, respectively. There was a similar mortality for 1B6 or PBS treatment at 3 h after infection. Thirteen of 15 (87%) 1B6 animals versus 16/17 (94%) PBS animals had positive CSF cultures at 48 h. No differences in mortality were observed in separate experiments where animals received 1B6 or PBS 3 or 24 h after infection with Hib and were treated with a single ampicillin dose (100 mg/kg) 24 h after infection. The median CSF white blood cell count/mm3 was 5627 and 4860 for the animals with meningitis receiving 1B6 and PBS, respectively, although the 1B6-treated animals had a lower percentage of polymorphonuclear cells in the CSF (P = 0.05). Histologic examination of the meninges, choroid plexus and cochlea showed a slight decrease in the numbers of inflammatory cells in animals treated with 1B6. 1B6 did not change the incidence of meningitis and only slightly decreased the degree of inflammation within the central nervous system, although animals treated with 1B6 have an altered CSF leucocyte response with the presence of more mononuclear cells as opposed to polymorphonuclear cells in their CSF. 1B6 may play a role in inhibiting neutrophil emigration to sites of inflammation within the central nervous system but is not beneficial in decreasing mortality in an infant rat model of H. influenzae type b sepsis and meningitis.
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PMID:Anti-CD11b monoclonal antibody in an infant rat model of Haemophilus influenzae type b sepsis and meningitis. 906 41

Nonbacterial thrombotic endocarditis (NBTE) is characterized by the deposition of thrombi on undamaged heart valves and by the increased frequency of associated arterial embolic events in patients with chronic debilitating diseases. Fifteen subjects diagnosed by necropsy of nonbacterial thrombotic endocarditis (NBTE) were studied to evaluate the general features, associated diseases, arterial embolic events, distribution and characteristics of histologic lesions. The most common underlying disease was neoplasm, which was present in 10 cases. Of these, 6 were adenocarcinomas, 3 hematological, and the remaining case was a bladder carcinoma. Other associated diseases included amyloidosis, MELAS syndrome, and sepsis. In most cases peripheral arterial embolic events were detected (9 cases). The central nervous system and the lung were involved in 7 cases (78%), heart and kidneys in 5 cases (56%), and spleen in 4 cases (44%). Other involved organs included pancreas, thyroid gland, testicles, meninges, liver and adrenal glands. The left valves were predominantly involved. The mitral valve in eight cases and the aortic valve in six cases. All cases with right involvement had the antecedent of central venous catheterization. Subendothelial fibrosis was a common histological finding which revealed the chronicity of the disease.
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PMID:[Nonbacterial thrombotic endocarditis: a review of a necropsy series]. 910 84

Although it is generally accepted that pro-inflammatory cytokines produced by cells of the central nervous system play important roles in the communication between the central nervous system and the immune system during sepsis, it is not clear whether these cytokines are produced in the brain under subseptic conditions. In this study, we used in situ hybridization to examine the mRNA expression of the pro-inflammatory cytokines IL-1beta and TNFalpha in the brains of rats 2 and 12 h after they were challenged by peripheral injections of lipopolysaccharide (LPS) ranging from 0.01 to 1000 microg/kg. Unlike septic doses of LPS (> 500 microg/kg), which induce global expression of pro-inflammatory cytokines in the brain, subseptic doses of LPS (0.01-10 microg/kg) induced IL-1beta and TNFalpha mRNA expression only in the choroid plexus, the circumventricular organs, and meninges. The expression of the cytokine-responsive immediate early gene I kappaB alpha was induced in the brain after doses of LPS as low as 0.1 microg/kg. I kappaB alpha mRNA expression was confined to sites where IL-1beta and TNFalpha were expressed. These results indicate that the induction and action of pro-inflammatory cytokines during subseptic infection occur at the blood-brain barrier and at circumventricular organs, which may be sites for elaboration of signal molecules that communicate peripheral immune status to the brain.
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PMID:Induction of pro-inflammatory cytokine mRNAs in the brain after peripheral injection of subseptic doses of lipopolysaccharide in the rat. 1037 70

Clinical features and diagnostic and prognostic values of systemic inflammatory response syndrome (SIRS) were studied in 158 children with rhino-sinusogenic orbital and intracranial complications. Patients, whose condition was more severe, showed more SIRS markers and more often needed surgical removal of the primary infectious process in paranasal sinuses (31%). Increase of the SIRS symptoms led to an increase of organic dysfunction from 3.3% to 53.3%. The main targets for shock are the brain and meninges, with the lungs being often the second target and the hemostasis system being also often involved. Complicated rhinosinusitis should be regarded as septic if in addition to the primary infectious process the child has two or more SIRS symptoms and signs of organic dysfunctions. This approach to the diagnosis and treatment of sepsis results in recovery of 98.5 of children with this condition.
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PMID:[Syndrome of systemic inflammatory response in children with septic pyogenic complications of rhinosinusitis]. 1269 56


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