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

A 73-year-old patient with a cerebral abscess of tuberculous etiology localized in the left parietooccipital region is presented. Clinically it had behaved like an expansive process. The inside of the abscess contained a purulent exudate with polynuclear cells and necrotic material. The wall of the abscess was formed by a predominantly histiocytic internal layer and an external one composed by histiocytes with the morphology of epithelioid cells. No tuberculous granulomas were found. The histiocytes contained a large number of acid-alcohol resistant bacilli. In the exudate Mycobacterium tuberculosis hominis was bacteriologically isolated. After the surgical operation the patient developed an acute tuberculous sepsis with tuberculous exudative meningitis and miliary dissemination in various organs. As regards the pathogenesis of the tuberculous cerebral abscess the authors consider the possible influence of a deficitary immune state of the patient and the aggressiveness of the infective organism.
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PMID:[Tuberculous cerebral abscess. Morphopathologic study (author's transl)]. 49 87

Non-otogenic cerebral abscess is becoming relatively more frequent compared with otogenic. It arises in a setting of sepsis, trauma, or congenital heart disease. The onset presents a meningo-encephalitic picture, often with two stages, followed by epilepsy and/or a hemiparesis. The best investigations are an EEG and, probably, an isotope scan. The angiogram may be misleading as 40% may not have a midline shift. 'Acute localized non-suppurative encephalitis' seems to be more frequent than in the past. Antibiotics and aspiration appear to be the best treatment.
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PMID:Non-otogenic cerebral abscess. 414 39

Pharmacokinetics of ceftizoxime (CZX), a new cephalosporin antibiotic, was investigated in 9 children with normal renal and hepatic function. In addition, the clinical effect of CZX was evaluated in 26 pediatric patients with various infections. In 4 of the 9 children with normal renal and hepatic function, intravenous bolus injection of CZX in a dose of 20 mg/kg yielded a mean peak serum level of 36.5 micrograms/ml at 1/2 hour after infusion, and mean serum levels of 12.5 micrograms/ml at 2 hours and 6.0 micrograms/ml at 4 hours after infusion. The biological half-lives of CZX were estimated to be 1.25--2.55 hours. In another child, serum levels of CZX at 1/2, 2 and 4 hours after intravenous bolus injection in a dose of 10 mg/kg were 19.60, 5.96 and 2.06 micrograms/ml, respectively. The clear difference in dose response between 20 mg/kg and 10 mg/kg reflected the doubled dose levels. In the remaining 4 children, drip infusion of CZX in a dose of 20 mg/kg (1 child 17 mg/kg) over 0.5--1.5 hours yielded peak serum levels at the end of infusion. The biological half-lives of CZX were estimated to be 0.95--1.50 hours. About 80% of CZX was excreted in the urine within 6 hours after infusion in the 4 children tested. Twenty-six pediatric patients with various infections were treated with CZX intravenous doses of 20 mg/kg to 118 mg/kg b.i.d.--q.i.d. for 3--14 days. Of the 12 patients with acute bronchitis and pneumonia, 5 showed excellent response, 6 good and 1 fair response. Of the 5 patients with urinary tract infection, 4 showed excellent response and 1 good response. One patient each with colitis, tonsillitis and facial cellulitis, pharyngitis showed excellent response and 1 patient each with purulent thyroiditis and gluteal abscess showed good response. The single patients with sepsis showed excellent response. One patient each with pyothorax, purulent arthritis and cerebral abscess showed poor response. Overall effectiveness rate was 84.6%. although 22 of all 26 patients treated had serious underlying diseases such as APL, AML. A mild increase in GOT and GPT was observed in 1 patient during treatment with CZX, and the values returned to normal after discontinuation of the drug. These results suggest that ceftizoxime is 1 of the most important antibiotics for treating a wide range of infections in children as well as in adults.
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PMID:[Pharmacokinetics and clinical evaluation of ceftizoxime (author's transl)]. 627 8

A parenteral formulation of rifampicin (Rimactan i.v., Ciba-Geigy, Basel, Switzerland) was administered to 237 critically ill or comatose patients, or patients with gastro-intestinal or absorption problems. There were 160 patients suffering from tuberculosis, 77 suffering from non-tuberculous (non-tb) infections including 30 cases of sepsis, 8 cases of bacterial meningitis and/or cerebral abscess and 9 patients with Legionnaires' disease. The usual daily dose of rifampicin was 450-600 mg, administered in most cases by i.v. bolus (122 cases) or i.v. drip infusion (79 cases) for a period of 1-113 days. Rifampicin was in all cases combined with one or more antimicrobial drug(s). The physicians considered the therapy as successful when the treatment with oral rifampicin could be instituted soon after parenteral administration or when the patients markedly improved their clinical condition. Of a total of 123 tuberculous patients for whom assessment of efficacy was possible, 100 (81.3%) showed favourable clinical results. Of 40 non-tb patients who could be analysed for clinical progress, 32 (80.0%) had a favourable outcome. Special attention should be drawn to the 11 patients with proven staphylococcal infections, of whom 10 were cured clinically and/or bacteriologically. Thrombophlebitis occurred in 10 out of the 237 (4.2%) patients, almost always in patients who were treated for more than 30 days. Systemic unwanted effects occurred in 14 (5.9%); the relationship to the treatment was not always established. Treatment was withdrawn due to unwanted effects in 5 (2.1%) of the 237 patients. Taking into account the severe, life-threatening infections reported, the results suggest that i.v. rifampicin is useful and in some critically ill patients even life-saving. Tolerability was good, even in long-term i.v. administration, although there seems to be the possibility that thrombophlebitis might develop if treatment is continued over 30 days.
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PMID:Parenteral rifampicin in tuberculous and severe non-mycobacterial infections. Clinical data on 237 patients. 709 64

The authors reported on a 11 day-old child, admitted in Neonatal Intensive Care Unit for multiple congenital malformations, who had sepsis and bacterial endocarditis. Among the risk factors for endocarditis were outstanding: the central venous catheterism, hemoculture with growth of Staphylococcus aureus and mechanical ventilation. The diagnosis was made in the 61st day after admission owing to the presence of persistent fever and appearance of systolic murmur. The echocardiogram revealed a thrombus in the right atrium measuring 1.9 x 0.7 mm. Antibiotic therapy and surgical resection being performed, with clinical improvement. On the 125st day after admission the patient died owing sepsis and cerebral abscess. At necropsy, heart malformations were not observed. The authors concluded to be very important the knowledge of the potential risks of invasive procedures currently used to care for critically ill newborns. The clinical suspicion of endocarditis should be considered in all neonates with sepsis and receiving intensive care for long time.
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PMID:[Bacterial endocarditis as a complication of neonatal sepsis: case report]. 1075 47

One percent of all pregnancies are found to have an antenatal abnormality; of these, 20% involve the genitourinary system. Today, controversy still exists regarding the postnatal management of some antenatal abnormalities detected by ultrasound. We present a case in which antenatal hydronephrosis initially detected by ultrasound appeared to resolve in utero. Postnatally, the child developed Citrobacter diversus urosepsis, meningitis, and cerebral abscess. Voiding cystourethrogram obtained after resolution of sepsis revealed grade IV reflux. This case underscores the importance of a full postnatal evaluation for all children with antenatal hydronephrosis and alerts clinicians to a virulent pathogen not commonly associated with urinary tract infection.
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PMID:Citrobacter diversus urosepsis and cerebral abscess in a child with antenatal hydronephrosis. 1075 58

Rhodococcus equi is a rare form of opportunistic infection in humans, more common in the immunocompromised. We present a case of pulmonary infection and subsequent cerebral abscess secondary to R. equi in a patient receiving immunosuppression for a c-ANCA positive vasculitis. Heightened awareness of R. equi infection is important when considering immunocompromised patients presenting with sepsis, especially those with cavitating pulmonary lesions and normal respiratory commensals on culture. Delays in diagnosis and treatment can cause increased patient morbidity and mortality.
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PMID:Rhodococcus equi infection during treatment of a c-ANCA positive vasculitis: a case report. 1701 8

Infections with Clostridium perfringens usually manifest locally or spread to sepsis with multiorgan involvement, hemolysis or septic shock. Central nervous system (CNS) manifestations are rare and most frequently comprise meningitis with or without pneumencephalon, encephalitis, plexitis, cerebral abscess, or subdural empyema. The course of CNS affections is usually foudroyant and the outcome fatal. Neuromuscular manifestations of C. perfringens infections are much more frequent than CNS manifestations and comprise myonecrosis (gas gangrene), rhabdomyolysis, myositis, fasciitis, affection of the neuromuscular transmission, or affection of the peripheral nerves. C. perfringens infections usually start from the site of a recent surgical wound or trauma, a gastrointestinal or urogenital problem, or occur in association with malignancy. In quite a number of cases the source of origin remains speculative. Treatment of choice is surgical debridement of the infectious focus with radical removal of all necrotic tissue, resection of the corresponding lymphatics in addition to antibiotic therapy with penicillin G, aminoglycosides, or clindamycin or hyperbaric oxygenation. Despite these therapeutic options, the prognosis of CNS and neuromuscular involvement in an infection with C. perfringens is still poor. Only focal infections or clostridial brain abscesses may eventually have a more favorable outcome, if surgery and antibiotics are instantly provided. Generally, early recognition of the infectious agent is of paramount importance to prevent from spreading and the development of severe hemolysis, septic shock, or death.
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PMID:Neuromuscular and central nervous system manifestations of Clostridium perfringens infections. 1803 7

Brain abscess is a rare but very dangerous neurosurgical lesion. Prompt diagnosis and emergency surgical evacuation are the hallmarks of therapy. Brain abscess following ischemic and hemorrhagic stroke is a rare entity. These cases are often preceded by episodes of bacteremia, sepsis, and local infection. The authors report the case of a 30-year-old woman who presented with a cerebral abscess at the site of a recent intraparenchymal hemorrhage.
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PMID:Brain abscess formation at the site of intracerebral hemorrhage secondary to central nervous system vasculitis. 1851 42

Shunt infections are a common complication of ventriculoperitoneal (VP) shunts, but the formation of a brain abscess related to a shunt system is very rare. A 44-year-old woman had a VP shunt inserted for hydrocephalus secondary to a subarachnoid hemorrhage. She suffered an episode of meningitis and sepsis 8 months after the shunt operation. After recovering from the meningitis, she complained of a loss of cognitive function. An enhancing mass was found in the frontal lobe, around the frontal horn of the lateral ventricle, and the ventricular catheter was embedded inside the mass. The ventricular catheter and cerebral abscess were removed using neuroendoscopy. We present an interesting case of a shunt-related brain abscess which illustrates the usefulness of neuroendoscopy.
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PMID:Delayed cerebral abscess as a shunt complication and endoscopic removal of the ventricular catheter and abscess. 1909 36


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