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 26-year-old male homosexual initially presented with Listeria monocytogenes sepsis and a small cell carcinoma of the rectum. His subsequent course included esophageal candidiasis, Pneumocystis carinii pneumonia, and severe T-lymphocyte abnormalities on immunologic testing, consistent with the acquired immunodeficiency syndrome (AIDS). This represents the first case of AIDS associated with this unusual tumor and Listeria infection.
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PMID:Listeria monocytogenes sepsis and small cell carcinoma of the rectum: an unusual presentation of the acquired immunodeficiency syndrome. 298 27

The effect of a multi-agent regimen on oropharyngeal candidiasis (OPC) prophylaxis in 16 consecutive pediatric bone marrow transplant patients was assessed. The multi-agent regimen consisted of: 1) debriding all mucous membrane surfaces within the oropharyngeal cavity with povidone-iodine 4 times a day, 2) swabbing all mucous membrane surfaces within the oropharyngeal cavity with nystatin 4 times a day, and 3) Ketoconazole given daily by mouth. Multi-agent regimen therapy was initiated on the day marrow ablative therapy began, and was terminated when the patient's absolute neutrophil count recovered to above 500/mm3. Baseline oropharyngeal fungal cultures indicated that 8 out of 16 (50%) of the patients were Candida carriers. Subsequent surveillance cultures indicated that 13 out of 16 (81.3%) of the patients had negative oropharyngeal fungal cultures during the entire period they were on the multi-agent regimen. The remaining three patients had negative oropharyngeal fungal cultures by the end of the experimental period. None of the patients developed Candida esophagitis or sepsis. The above regimen is an effective and non-toxic method to prevent oropharyngeal candidiasis in pediatric BMT patients.
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PMID:Oropharyngeal Candida prophylaxis in pediatric bone marrow transplant patients. 389 1

Candidiasis of the esophagus progressing to hard fibrosed strictures of the esophagus in 2 patients is reported. Both patients had deficient immunologic systems and received extended courses of broad-spectrum antibiotic therapy for control of sepsis. The strictures were progressive despite adequate antifungal therapy and several attempts at dilatations and necessitated visceral esophageal substitution as definitive surgical therapy.
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PMID:Candidiasis-induced esophageal strictures. 650 Feb 38

The case of a patient with Salmonella arizonae sepsis, esophageal candidiasis, and a low CD4+ T lymphocyte count is presented. Follow-up continued for over 2 years after the patient was discharged from the hospital, and his clinical course and clinical-immunological examinations are described. After a period of several years during which the patient had recurrent acute infectious episodes, he improved markedly after cholecystectomy and toilette of the gingival inlets for severe parodontopathy. His CD4+ T cell count increased although it remained below normal values. This case points to possible hypothesis that chronic infective foci may further compromise the immune system when a congenital functional or numerical CD4+ T cell deficit is present.
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PMID:[Idiopathic CD4+ T-lymphocyte deficiency: the clinical evolution of a case]. 977 72

During 1985 and December 1990 children referred to hospitals with HIV infection were subjected to a protocol previously established to determine HIV antibodies by ELISA and Western Blot methods. Children under 15 months of age underwent repeated tests to preclude the transfer of maternal antibodies. In this group only children with more than 6 months of follow-up were included. 17 cases were studied: 6 were children under 15 months of age, 8 were between 15 months and 5 years, and 3 were between 5 years and 15 years. 12 children originated from urban areas, 3 from rural areas, and 2 were foreigners. The clinical symptoms started in the first year of life in 8 cases, between 1 and 3 years in 7 cases, and after 5 years of age in 2 cases. HIV transmission was vertical in 8 cases, via blood transfusion in 2 cases, and in 7 cases the route of transmission could not be confirmed. The follow-up lasted 6 months for 5 cases; 18 months for 5 cases; 2 years for 4 cases; and 3.5 years for 3 cases. The clinical signs were predominantly: cutaneous lesions in 10 of the 17 cases, diarrheal disease in 7, fever in 6, malnutrition in 6, as well as hypertrophy, oral moniliasis, sepsis, esophageal candidiasis, otitis, and varicella in different patients. According to CDC classification, 9 cases corresponded to class P-1 (one of them with elevated immune function and the other with normal immune function); 6 corresponded to pediatric class P-2 (2 to subclass A, 2 to subclass D, and 2 to subclass D-2). 6 children died: 4 due to meningitis and sepsis, 1 due to varicella, and 1 due to malnutrition, sepsis, and esophageal candidiasis.
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PMID:[Pediatric AIDS: characteristics of 17 Dominican cases]. 1234 59

Voriconazole is a new second generation triazole effective against a wide spectrum of fungal pathogens. A randomised, controlled trial has shown it to be superior to amphotericin B in invasive aspergillosis, and it is a potential alternative to amphotericin B in neutropenic sepsis and to fluconazole in oesophageal candidiasis. Early clinical reports and in vitro susceptibility data suggest that it may also be a valuable antifungal against fluconazole-resistant Candida species and certain emerging fungal pathogens, which cause infections that are often refractory to conventional therapies. There is limited evidence of azole cross-resistance of clinical importance. Voriconazole is available as intravenous and oral formulations and has excellent tissue penetration and a good safety profile, the main problems being transient visual impairment and hepatotoxicity in patients with liver disease. It is metabolised by cytochrome P-450 isoenzymes causing important drug interactions but, in contrast to amphotericin B, is safe in renal failure and rarely causes infusion-related reactions. This review outlines the pharmacology of voriconazole and focuses on its clinical applications and safety profile.
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PMID:Voriconazole for serious fungal infections. 1499 74

A 45-year-old homosexual man with pneumocystis pneumonia and esophageal candidiasis tested positive in ELISA and Western blot analysis for HIV-1. His CD4+ T cell count was 43/microL and his HIV-RNA load was 250,000 copies/mL. He was treated with Trimetoprim-Sulfamethoxazole, Prednisolone and Fluconazole. Valganciclovir was added to treat CMV retinitis. During the clinical course, 21 days after admission, the patient presented with a temperature of 39 degrees C and blood analysis showed neutropenia. Cefepime and G-CSF were initiated, but new consolidation was observed in the upper left lobe in chest radiography. He underwent bronchoscopy and lavage culture was positive for Aspergillus fumigatus. Serum testing of galactomannan was also positive and pulmonary aspergillosis was diagnosed. The patient was initially treated with Micafungin but switched to Voriconazole when clinical symptoms worsened. An eventual clinical response was observed and pulmonary aspergillosis was controlled. Unfortunately, he died of sepsis due to MRSA 2 months later. Pulmonary aspergillosis is a devastating complication with poor prognosis in patients with HIV infection. Amphotericin-B has been the mainstay of pulmonary aspergillosis treatment, but reports indicate mortality exceeding 80%. Use of Voriconazole, a relatively new antifungal agent, may lower mortality with fewer adverse effects than conventional antifungal therapy.
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PMID:[Voriconazole as an effective therapy against pulmonary aspergillosis in a man with immunodeficiency virus-infection: a case report]. 1744 80

Esophageal candidiasis (EC) is the most common type of infectious esophagitis. In the gastrointestinal tract, the esophagus is the second most susceptible to candida infection, only after the oropharynx. Immunocompromised patients are most at risk, including patients with HIV/AIDS, leukemia, diabetics, and those who are receiving corticosteroids, radiation, and chemotherapy. Another group includes those who used antibiotics frequently and those who have esophageal motility disorder (cardiac achalasia and scleroderma). Patients complained of pain on swallowing, difficulty swallowing, and pain behind the sternum. On physical examination, there is a plaque that often occurs together with oral thrush. Endoscopic examination is the best approach to diagnose this disease by directly observing the white mucosal plaque-like lesions and exudates adherent to the mucosa. These adherent lesions cannot be washed off with water from irrigation. This disease is confirmed histologically by taking the biopsy or brushings of yeast and pseudohyphae invading mucosal cells. The treatment is by systemic antifungal drugs given orally in a defined course. It is important to differentiate esophageal candidiasis from other forms of infectious esophagitis such as cytomegalovirus, herpes simplex virus, gastroesophageal reflux disease, medication-induced esophagitis, radiation-induced esophageal injury, and inflammatory conditions such as eosinophilic esophagitis. Except for a few complications such as necrotizing esophageal candidiasis, fistula, and sepsis, the prognosis of esophageal candidiasis has been good.
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PMID:Diagnosis and Treatment of Esophageal Candidiasis: Current Updates. 3177 27