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

Recent advances in prevention, diagnosis, and treatment of infection-associated preterm labor are discussed. This includes antepartum treatment of vaginal infections, amniocentesis for culture and glucose levels, and adjunctive antibiotic treatment of preterm labor and preterm premature rupture of the membranes. Risk factors for neonatal group B streptococcus sepsis are described and testing for rapid detection of maternal group B streptococcus colonization is discussed, as are recent prospective studies of pregnancy outcome following human parvovirus B19 infection. Studies quantifying the transmission of herpes simplex virus to neonates following vaginal delivery to mothers with recurrent infections are discussed, as well as the results of several studies using rapid detection kits for the virus.
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PMID:Obstetric and neonatal infection. 195 5

A continuous flow immunoadsorption system consisting of a cell separator, protein A-sepharose columns, and a semi-automatic elution component was developed to specifically remove circulating IgG. This system provides extensive absorption with an essentially unlimited column bed volume. Six dogs were treated a total of 19 times. In no case did fever, sepsis, or respiratory distress result from the treatment. Serial blood counts and tests of liver and renal function remained in the normal range. Ex vivo perfusion of one plasma volume caused an acute drop in IgG levels of approximately 50 percent. This was reflected in a similar decrease in specific antibody levels to sheep erythrocytes, bovine serum albumin, and canine parvovirus. Antibody kinetics following immunoadsorption were variable, but in several cases, antibody levels remained lowered. This immunoadsorptive system appears to be a safe and effective alternative to plasma exchange for removal of IgG antibodies.
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PMID:Specific removal of antibodies with an immunoadsorption system. 636 56

It was proved in the 1980s that human herpesvirus-6 and human parvovirus B19 cause diseases in humans. Human herpesvirus-6, a newly recognized herpesvirus, is a causative agent of exanthem subitum. The virus produces broad clinical features; complications, including fatal outcome, are frequently activated in immunosuppressed conditions such as organ transplantation. Parvovirus B19, a small-DNA virus, infects erythroid progenitor cells. Systemic infection with parvovirus B19 is responsible for several clinical entities, such as erythema infectiosum, arthropathy, aplastic crisis, fetal death, and other disease conditions, including those in immunosuppressed hosts. Reliable diagnostic technologies and carefully designed clinical, immunologic, and virologic studies will fully delineate the clinical significance of both viral infections.
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PMID:Human herpesvirus-6 and parvovirus B19 infections in children. 839 41

Analysis of the synovial fluid is the major investigation of monoarthritis. Appearance, viscosity (low if inflamed), cell number and differential, presence of crystals or organisms are all relevant. If septic arthritis is suspected, culture of other sites such as blood, urine, sputum etc. is essential, and may alone yield the organism. If mycobacterium is possible, synovial membrane staining and culture is usually necessary. Gonococcal may be lost in culture if the specimen is not immediately processed. Partially treated sepsis may produce sterile culture, and early work suggests that P.C.R. may diagnose these cases. Other investigations such as erythrocyte sedimentation rate, C-reactive protein indicate inflammatory activity, though they are not specific. Antibodies such as antinuclear antibodies, rheumatoid factors lead towards an "autoimmune" disease diagnosis, that do not alone measure activity. Specific antibodies to virus e.g. parvovirus may be diagnostic. The monoarthritis must be seen in the total patient context, where often clues e.g., asymptomatic uveitis (in juvenile chronic arthritis) and psoriasis may give the diagnosis.
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PMID:[Laboratory diagnosis of monarthritis: how much, what for, when?]. 850 31

The risk of acquiring diseases from transfusion of blood and blood products is well recognized and the issue of parvovirus in haemophiliacs is not a new one. We report two patients with haemophilia acquiring iatrogenic parvovirus B19 infection, resulting in life-threatening sepsis in one, and immunocompetent adult. Over the last 10 years there has been great progress in manufacturing safer products with regard to enveloped viruses such as HIV, hepatitis B and C. A recent outbreak across Europe of hepatitis A in haemophiliacs treated with plasma-derived factor VII concentrates has made haemophilic treaters concerned about the known (parvovirus B19 and hepatitis A) and the unknown non-lipid enveloped viruses that may be contained in the clotting factor concentrates, because these are resistant to the existing viral inactivating techniques. The possibility of HIV itself mutating into a non-lipid enveloped virus emphasizes the need to seek and use safer products.
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PMID:Transmission of symptomatic parvovirus B19 infection by clotting factor concentrate. 863 48

We examined the expression of the CD45RO antigen, which characterizes the antigen primed/memory phenotype of T lymphocytes, as a marker for congenital infection in blood samples of newborns and fetuses. CD45RO expression on T cells was determined by triple-colour fluorescence flow cytometry. In total 537 blood samples of newborns and infants up to an age of 3 months and 89 fetal blood samples from gestational weeks 19-31 were analysed. Of the newborns and infants, 74 had a clinically, serologically and/or antigenically evident infection, and four of the fetuses had a confirmed intra-uterine infection. In 35 infants with acute predominantly bacterial infections such as sepsis or pneumonia, 17 (48.6%) had elevated CD45RO(bright) expression. In 39 infants with proven pre-, peri- or early post-natal infections with toxoplasmosis, cytomegalovirus (CMV), rubella, herpes simplex virus (HSV) or human herpes virus type 6 (HHV6), 25 (64.1%) exhibited enhanced CD45RO(bright) expression. Three of four fetuses with confirmed intra-uterine infection (three with CMV, one with parvovirus B19) exhibited elevated CD45RO(bright) expression. The specificity of the CD45RO assay for detecting microbial infections was 94.6% for newborns and infants up to 3 months and 90.6% for fetuses. It is concluded that elevated numbers of CD45RO(bright) T cells in infants up to 3 months of age strongly suggest an infection. However, the sensitivity of the CD45RO assay is not sufficient to enable the test to be used as a general marker for prescreening infants to detect pre-, peri- or early post-natally acquired infections.
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PMID:Diagnostic value of CD45RO expression on circulating T lymphocytes of fetuses and newborn infants with pre-, peri- or early post-natal infections. 903 Aug 68

Palpable purpura is the hallmark of cutaneous vasculitis. Small-vessel vasculitis is a common vasculitis manifestation associated with acute or chronic infection. It is also characteristic of a systemic disease whether infectious or not. The pathogenic mechanisms appear to be complex: immune complex formation, vessel damage or altered vessel function mediated directly by infectious agents, humoral or cellular immunologic response. It is also a reaction to mixed cryoglobulinemia. Diagnosis of cutaneous vasculitis is simple (palpable purpuric eruption, nodules, vesiculobullous lesions, ulcerations), but etiological investigation is often difficult because the infectious origin is only rarely demonstrated. This type of purpura occurs in bacterial endocarditis and therefore blood cultures must be performed in any febrile patient particularly in the presence of a cardiac murmur. In fact the viral, parasitic or bacterial infectious origin is demonstrated in less than 30% of the cases of leucocytoclastic vasculitis. While focal sepsis is often found and its eradication should be followed-up, its role has not been proven particularly as antibiotics alone themselves can cause hypersensitivity vasculitis. Finally, mention must be made of virus induced vasculitis (B and C hepatitis, cytomegalovirus, parvovirus), antiviral treatment which permits better control of vasculitis.
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PMID:[Infection and vascular purpura]. 1046 26

Syncytial giant cell hepatitis in the neonatal period has been associated with many different etiologic agents and may present initially as cholestasis. Infectious causes are most common and include: (1 ) generalized bacterial sepsis, (2) viral agents, (3) toxoplasmosis, (4) syphilis, (5) listeriosis, and (6) tuberculosis. Viral hepatitis may be due to cytomegalovirus, rubella virus, herpes simplex, HHV-6, varicella, coxsackievirus, echovirus, reovirus 3, parvovirus B19, HIV, enteroviruses, paramyxovirus, and hepatitis A, B, or C (rare). Giant cell hepatitis may result in fulminant liver failure with massive hepatocyte necrosis and severe liver dysfunction leading to death, resolution with severely compromised liver function, or liver transplantation. The authors report a 6-week-old male who had an unremarkable perinatal period, became jaundiced after developing diarrhea, and subsequently developed liver dysfunction with massively increased liver enzymes and a coagulopathy. Open wedge and core liver biopsies were performed to determine if the patient should be listed for liver transplantation. Giant cell hepatitis with a significant mixed lymphocytic and neutrophilic infiltrate was present on both the wedge and core biopsies. The residual 60% of hepatocytes had ballooning degeneration and many possessed pyknotic nuclei. The hepatocytes were arranged in a pseudoacinar pattern. Electron microscopy showed paramyxoviral-like inclusions in the giant cells, characterized as large inclusions with fine filamentous, beaded substructures (18-20 nm). Paramyxoviridae are nonsegmented, negative-sense, single-stranded RNA viruses. This family is divided into the Paramyxovirinae subfamily containing respirovirus (Sendai virus, parainfluenza virus type 3), rubulavirus (mumps, parainfluenza virus type 2), and morbillivirus genera (measles); and Pneumovirinae subfamily (pneumovirus genus [respiratory syncytial virus]). Supportive care to determine if hepatic function resolves following the viral episode, liver transplantation with fulminant liver failure, and ongoing evaluation in those who recover to assess chronic liver disease are necessary. Ultrastructural evaluation may unmask the etiologic agent for hepatitis and direct therapy.
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PMID:Neonatal syncytial giant cell hepatitis with paramyxoviral-like inclusions. 1129 22

Case records of 232 dogs and 29 cats with neutropenia were reviewed to examine the spectrum of underlying etiologies causing the neutropenia. Six etiological categories included nonbacterial infectious disease; increased demand due to marked inflammation, bacterial sepsis, or endotoxemia; drug-associated neutropenia; primary bone-marrow disease; immune-mediated neutropenia; and diseases of unclear etiology. The largest single category associated with the development of neutropenia was nonbacterial infectious disease (e.g., feline leukemia virus [FeLV], feline immunodeficiency virus [FIV], histoplasmosis, cryptococcosis, and parvovirus), with parvovirus infection accounting for 47.1% of all cases. The least common (0.38%) cause was naturally occurring immune-mediated neutropenia.
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PMID:Neutropenia in dogs and cats: a retrospective study of 261 cases. 1130 May 19

To better define the incidence and causes of canine pancytopenia, we retrospectively evaluated the results of complete blood counts submitted to the University of Minnesota Veterinary Teaching Hospital during a 1-year period. Pancytopenia was defined as packed cell volume < 36%, total leukocyte count < 6,000/microliter or total segmented neutrophil count < 3,000/microliter, and platelet count < 200,000/microliter. Of 4,560 complete blood counts, 110 (2.4%) samples from 51 dogs met the criteria for pancytopenia. Eleven different disease processes were identified. These included chemotherapy-associated pancytopenia (n=22), parvovirus infection (n=5), malignant histiocytosis (n=5), idiopathic aplastic anemia (n=3), sepsis (n=3), myelodysplastic syndrome (n=3), immune-mediated hematologic disease (n=3), lymphoblastic leukemia (n=2), ehrlichiosis (n=2), estrogen toxicity (n=2), and multiple myeloma (n=1). Malignant histiocytosis and idiopathic aplastic anemia occurred more frequently than was expected. Doxoruicin was the chemotherapeutic agent associated with pancytopenia. Hematologic recovery and patient survival time varied with the cause of pancytopenia; therefore, a specific diagnosis was essential for establishing prognosis. Differentiation among causes of pancytopenia requires a systemic approach that includes elimination of infectious and drug-induced causes, and examination of bone marrow aspiration and core biopsy specimens.
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PMID:A retrospective study of canine pancytopenia. 1207 15


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