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 72-year-old male is described with a history of 4 episodes of Pseudomonas aeruginosa sepsis and chronic otitis media caused by pseudomonas species. In vitro testing of the patient's polymorphonuclear leukocytes (PMNs) revealed profoundly abnormal chemotactic responses and defective intracellular killing of Ps. aeruginosa, Staphylococcus aureus and Escherichia coli. Chemiluminescence production by the patient's PMNs in response to opsonized zymosan as well as endotoxin stimulated nitroblue tetrazolium dye reduction were markedly depressed. These data indicate the presence of a profound, apparently acquired, defect in PMN function in an elderly male. Detailed evaluation of adult patients with recurrent infections may reveal similar, apparently acquired defects in PMN function.
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PMID:Recurrent Pseudomonas infection associated with neutrophil dysfunction. 10 88

Thirty children over the age of one month were treated with amikacin (BBK8), a new aminoglycoside derived from kanamycin A, with three intramuscular dosage schedules. Each group consisted of ten patients. The first received 7-5 mg/kg/12 hours, the second 7-5 mg/kg/24 hours and the third, 3-75 mg/kg/12 hours. The infections and the bacteria were similar in all three groups: pyelonephritis, abscesses of soft tissues, infected wounds, septicaemia, superinfected empyema, gastro-enteritis, chronic otitis media; the bacteria were E. coli, Klebsiella, Pseudomonas and Salmonella. A were sensitive by the Kirby-Bauer method, although two were resistant by dilution in Petri dish. Of the thirty patients, twenty four (80%) were cured. The schedule of 3-75 mg/kg/12 hours was as effective as the schedule of 7-5 mg/kg/12 hours for infections such as pyelonephritis, superficial abscesses, contaminated wounds, gastro-enteritis and sepsis. The cases with infections localized in rather unaccessible sites required double the dose and strict drainage and cleanliness. Plasma levels with the administration of 3-75 mg/kg fluctuated between 8-3 and 12-6 mcg/ml; with 7-5 mg/kg they fluctuated between 8-6 and 13-1. The minimum inhibitory level (MIL) for the majority of the bacteria was 1-25 mcg/ml. No toxic reactions were observed.
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PMID:Amikacin (BBK8) in infections due to gram-negative organisms in children over the age of one month. 102 22

From January 1980 to July 1990, the Hospital Infections Program of the Centers for Disease Control conducted 125 on-site epidemiologic investigations of nosocomial outbreaks. Seventy-seven (62%) were caused by bacterial pathogens, 11 (9%) were caused by fungi, 10 (8%) were caused by viruses, five (4%) were caused by mycobacteria, and 22 (18%) were caused by toxins or other organisms. The majority of fungi and mycobacterial outbreaks occurred since July 1985. Fourteen (11%) outbreaks were device related, 16 (13%) were procedure related, and 28 (22%) were product related. The proportion of outbreaks involving products, procedures, or devices increased from 47% during 1980-1985 to 67% between 1986 and July 1990. Recent outbreaks have shown that packed red blood cell transfusion-associated Yersinia enterocolitica sepsis results from contamination of the blood by the asymptomatic donor; that povidone-iodine solutions can become intrinsically contaminated and cause outbreaks of infection and/or pseudoinfection; and that rapidly growing mycobacteria can cause chronic otitis media, surgical wound infection, and hemodialysis-associated infections. These and other outbreaks demonstrate how epidemiologic and laboratory investigations can be combined to identify new pathogens and sources of infection and ultimately result in disease prevention.
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PMID:Nosocomial outbreaks: the Centers for Disease Control's Hospital Infections Program experience, 1980-1990. Epidemiology Branch, Hospital Infections Program. 165 44

Among 5 patients with bacteremia due to Fusobacterium necrophorum, 3 young adults had post-anginal sepsis (Lemierre syndrome), including one with the classical secondary metastatic complications of pulmonary abscesses, pleural empyema, arthritis and hepatobiliary disturbances. The primary focus was a cholangiogenic abscess in an 81-year-old woman, and fetid otitis following a radical operation for cholesteomatous chronic otitis media in a 29-year-old male. Septicemia due to Fusobacterium necrophorum, and in particular Lemierre syndrome, are presented in the light of the literature.
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PMID:[Sepsis caused by Fusobacterium necrophorum: the re-discovered postangina sepsis Lemierre syndrome and other manifestations]. 232 13

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

Factors present in skin appear to enhance bone resorption in chronic otitis media. These skin factors were replicated in a series of experiments using an animal model. The presence of activated granulation tissue is a universal finding in bone resorption in otitis media. Skin promotes bone resorbing connective tissue by the action of keratin as a foreign body, by the enhancement of middle ear sepsis, by stimulation and activation of inflammatory cells and most importantly through the creation of pressure.
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PMID:Pathogenic factors in bone resorption in cholesteatoma. 620 36

Anaerobic bacteria outnumber aerobes at most oropharyngeal sites, with counts up to 10(11)/ml of fluid, and have been implicated in infections of all structures of the head and neck. They are common in chronic otitis media, chronic sinusitis, and various soft-tissue infections. These infections are initiated primarily by mucosal breaks. Bacterial factors such as adhesiveness and antileukocytic activity also may play a role. Among the complications of these infections are brain abscess, aspiration pneumonia, and anaerobic sepsis. Treatment includes surgical drainage and use of antimicrobial agents active against the mixed flora commonly found. Penicillin is currently the drug of choice, but this may change with the emergence of beta-lactamase-producing strains of anaerobes such as Bacteroides melaninogenicus.
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PMID:Anaerobes in infections of the head and neck and ear, nose, and throat. 637 19

The occurrence of sinusitis and middle ear effusions has frequently been attributed to the obstruction of the sinus ostia and/or eustachian tube. In the intensive care unit setting, edema caused by the irritation from nasogastric, nasotracheal and orotracheal tubes has been associated with this pathology and has been responsible for occult sepsis in this population. Our investigation was performed to determine the risk of chronic otitis media with effusion necessitating myringotomy with tympanostomy tubes among tracheotomized, ventilator dependent children in a consecutive series of children admitted to our recently created stable ventilator unit. We retrospectively reviewed the medical records of all tracheotomized, chronically ventilator dependent children < 48 months of age who had been hospitalized in this unit from the initial opening in September 1990 to January 1993. Data collected consisted of patient demographics, gestational age, cognitive abilities, age at onset of mechanical ventilation, age at tracheostomy, age at myringotomy, presence of nasogastric and gastroenterostomy tubes and evidence of gastric-esophageal reflux. All children underwent a tracheostomy procedure subsequent to the onset of mechanical ventilation. Of these patients, 9/12 (75%) later required myringotomy with tympanostomy tube placement following the occurrence of chronic otitis media with effusion. Ventilation tubes for chronic otitis media with effusion were not required in 3 patients. Using a case control study design, we examined the need of myringotomy tubes for children requiring continuous mechanical ventilation versus those requiring night-time only ventilation. The risk of myringotomy tubes in the continuously ventilated group (9/9) was significantly greater than the risk in the intermittently ventilated group (0/3) P < 0.01.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Chronic otitis media requiring ventilation tubes in tracheotomized ventilator dependent children. 783 30

Meningiomas arising in or presenting as middle ear lesions are relatively uncommon. This study retrospectively reviews the clinicopathologic features of six meningiomas arising in or extending into the middle ear. The patients comprise five women and one man ranging in age from 45 to 67 years (median, 55 years) at the time of surgery. Five tumors arose in the posterior fossa or temporal bone region and one tumor arose from the auditory canal itself. Three tumors arose on the right side and three on the left. Duration of symptoms before surgery involving the middle ear was known in five patients and ranged from 2 to 13 years (median, 10 years). Symptoms at presentation included gait or balance problems (n = 3), chronic otitis media (n = 2), diplopia (n = 2), hearing loss (n = 2), pain (n = 1), aural polyp (n = 1), and tinnitus (n = 1). Histologically, all six tumors resembled a syncytial (meningotheliomatous) meningioma. Psamomma bodies were noted in two tumors and two tumors demonstrated mild nuclear pleomorphism. None of the tumors demonstrated histologic features of atypical meningioma. Follow-up information was available in five patients. Four patients had prior surgery for removal of posterior fossa temporal bone meningiomas and developed recurrences involving the auditory canal 60 to 84 months after surgery. At the time of most recent follow-up examination, three patients were alive with evidence of tumor (65, 112, and 214 months), one patient was alive with no evidence of tumor (99 months), one patient died in the postoperative period of sepsis and pneumonia following resection of a middle ear recurrence (64 months), and one patient was lost to follow-up analysis. Meningiomas arising in or extending to the middle ear canal are unusual. They more commonly arise in woman and in most cases involve extension of intracranial/cranial tumors into the canal.
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PMID:Middle ear meningiomas. 1091 84

Acute otitis media (AOM) is the most common disease for which pediatricians prescribe antimicrobial agents. Middle ear fluid were collected from 243 children with AOM that failed to respond to a previous course of antimicrobial therapy and who had then received myringotomy from September 1997 through August 1999. Bacterial cultures were done and antimicrobial susceptibilities were analyzed. Streptococcus pneumoniae (21.8%) was the most common causative organism, followed by Haemophilus influenzae (10.2%), Staphylococcus aureus (7%), and Pseudomonas aeruginosa (1.8%), while Moraxella catarrhalis (0.7%) and group A beta-hemolytic streptococcus (0.2%) were rarely isolated. In patients whose condition failed to improve after a course of antibiotic treatment, drug resistance became a serious problem. Fourteen percent of the patients in this series had complications, which included recurrent AOM, persistent middle ear effusion necessitating ventilation tube insertion, hearing impairment, mastoiditis, meningitis, chronic otitis media, brain abscess, and sepsis. Possible risk factors such as young age, male sex, underlying diseases, and a culture of S. pneumoniae or H. influenzae were not significantly associated with an increased incidence of complications. More stringent diagnosis and the correct choice of antibiotic treatment combined with the introduction of potential virus and bacterial vaccines are promising ways to reduce the morbidity of AOM in children.
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PMID:Pathogens in the middle ear effusion of children with persistent otitis media: implications of drug resistance and complications. 1160 10


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