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 full-term, small-for-gestational-age, neonate was born 4 days after rupture of the membranes. On the 5th day of life, she developed sepsis due to Klebsiella pneumoniae. On the 18th day of life, the right hip was noted swollen with limited range of motion, but it was painless on passive movements. Ultrasonography revealed abscess of the right ilio-psoas muscle with normal appearance of the right hip joint. Surgical incision and drainage and antibiotic administration resulted in a gradual full recovery. Ultrasonography can confirm the diagnosis of this exceptional clinical entity in neonates, which is difficult to differentiate from septic arthritis of the hip.
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PMID:Ilio-psoas abscess in a neonate. 939 59

Lack of IL-4 has been shown to be protective in some experimental models of infectious diseases in mice such as cutaneous leishmaniasis. At the same time IL-4, together with other Th2 cytokines, including IL-10 and IL-13, is known as an anti-inflammatory cytokine with the potential to down-regulate proinflammatory cytokine production. To investigate the role of IL-4 in experimental Staphylococcus aureus-induced and T lymphocyte-mediated arthritis, IL-4-deficient C57BL/6 mice (IL-4(-/-)) and their congenic controls (IL-4(+/+)) were inoculated with a toxic shock syndrome toxin-1-producing S. aureus strain. In IL-4(+/+) mice, arthritis peaked 14 days after bacterial inoculation, whereas, at that time, IL-4(-/-) mice displayed significantly less frequent (p < 0.05) joint inflammation. Paralleling lower frequency of arthritis, IL-4-deficient mice showed a decreased bacterial burden in joints (p = 0.014) and kidneys (p = 0.029), as well as lower infection-triggered weight decrease and mortality. In vitro, IL-4 inhibited intracellular killing of S. aureus in infected macrophages, without affecting phagocytosis. This finding may explain the enhanced staphylococcal clearance observed in IL-4(-/-) mice in vivo. Our results suggest that IL-4 and IL-4-dependent Th2 responses promote septic arthritis and sepsis-related mortality by inhibition of bacterial clearance during S. aureus infection.
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PMID:Staphylococcus aureus-induced septic arthritis and septic death is decreased in IL-4-deficient mice: role of IL-4 as promoter for bacterial growth. 959 Feb 59

Staphylococcus aureus is a major cause of nosocomial and community-acquired infections. Morbidity and mortality due to infections such as sepsis, osteomyelitis, septic arthritis, and invasive endocarditis remain high despite the use of antibiotics. The emergence of antibiotic resistant super bugs mandates that alternative strategies for the prevention and treatment of S. aureus infections are developed. We investigated the ability of vaccination with a recombinant fragment of the S. aureus collagen adhesin to protect mice against sepsis-induced death. Actively immunized NMRI mice were intravenously inoculated with the S. aureus clinical isolate strain Phillips. 14 d after inoculation, mortality in the collagen adhesin-vaccinated group was only 13%, compared with 87% in the control antigen immunized group (P < 0.001). To determine if the protective effect was antibody mediated, we passively immunized naive mice with collagen adhesin-specific antibodies. Similar to the active immunization strategy, passive transfer of collagen adhesin-specific antibodies protected mice against sepsis-induced death. In vitro experiments indicated that S. aureus opsonized with sera from collagen adhesin immunized mice promoted phagocytic uptake and enhanced intracellular killing compared with bacteria opsonized with sera from control animals. These results indicate that the collagen adhesin is a viable target in the development of immunotherapeutics against S. aureus.
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PMID:Vaccination with a recombinant fragment of collagen adhesin provides protection against Staphylococcus aureus-mediated septic death. 963 97

Clinical, laboratory and radiological data of 35 patients (> 60 years) with septic arthritis were retrospectively analyzed in 2 groups submitted to different treatment protocols based on the radiological stage of destruction. Group I: intraarticular gentamicin-PMMA beads (8 cases), group II: resection-arthroplasty with gentamicincement spacer (27 cases). The average diagnostic delay was 4.8 months. Diagnostic errors were: osteoarthrosis in 9 cases, periarthritis of the shoulder in 5, femoral head necrosis in 4 cases, sciatic pain in 3, osteoporosis in 1, and thrombosis in 1 case. The re-operation rate in group I was 1.4 (range 1-2 operations) and in group II 1.2 (range 0-3 operations). Fifteen patients were left with a resection-arthroplasty. The restriction of motion remained moderate in 6 and severe in 9 cases. Three patients had sepsis and died. The final results were poor after both treatment protocols. Early diagnosis seems to be the most determining factor concerning the final outcome of septic arthritis.
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PMID:Diagnosis and treatment of joint infections in elderly patients. 968 51

Nongonococcal septic arthritis can occur during the postpartum period. We report two cases, one involving the wrist and the sacroiliac joints and the other the pubic symphysis. The difficulty of initial diagnosis in the postpartum period is emphasized. This pathology is uncommon and may begin insidiously. The sacroiliac joint is particularly at risk for postnatal sepsis, but its deep localization hinders investigations. Besides the classical obstetrical infectious assessment (blood cultures, urine culture, vaginal sample, white blood cell count and CRP) and radiological investigations, joint puncture is needed to isolate the causal infectious agent. Joint immobilization in combination with major 3-month antibiotic therapy is usually successful, generally with no sequellae.
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PMID:[Postpartum septic arthritis. Two case reports]. 969 Jan 67

We reviewed eight children (ten shoulders) who had suffered neonatal sepsis, after a mean follow-up of 14 years (11 to 15). The delay between the onset of symptoms and diagnosis was one day in five patients, two days in three and seven days in one. All ten shoulders were treated by aspiration, followed by arthrotomy in two. At follow-up, five of the ten shoulders had a full range of movement and the others had minimal restriction of external rotation. Shortening of 10 cm was present in one patient, while two with bilateral involvement had disproportionally short humeri. Early diagnosis and treatment favour the outcome in septic arthritis of the shoulder. With late diagnosis, deformation of the humeral head and shortening of the humerus cause marked cosmetic abnormality but negligible functional loss.
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PMID:Late sequelae of neonatal septic arthritis of the shoulder. 969 29

Twenty-one compromised neonatal foals hospitalised at the Rural Veterinary Centre (RVC) during 1993 were studied to determine i) serum gentamicin concentrations obtained when gentamicin was administered at 3.3 mg/kg bwt twice daily i.m.; ii) factors which contributed to inter-foal variation in serum gentamicin concentrations achieved and iii) clinical efficacy of gentamicin therapy in foals with confirmed septicaemia. Septicaemia was confirmed in 7 foals with positive blood cultures and suspected in 8 foals with a sepsis score > 11. Peak serum concentrations (Ps) were > 6 microg/ml in all foals and > 8 microg/ml in 60% of foals. Trough serum concentrations (Ts) were < 2 microg/ml in all foals. Factors found to produce inter-foal variation in the Ps achieved included age (< 24 h; decreased), bodyweight (< 38 kg; decreased) and severity of dehydration (8-12% bodyweight; increased). Clinical response was not associated with achievement of Ps > 8 microg/ml, but was negatively influenced by the severity of clinical signs of depression. None of the foals in this study developed septic arthritis or pneumonia during or after therapy. No serum biochemical evidence (i.e. elevated serum creatinine concentrations) of gentamicin-induced nephrotoxicity was noted during therapy.
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PMID:Serum gentamicin concentrations in compromised neonatal foals. 970 16

To determine the incidence of joint sepsis following anterior cruciate ligament (ACL) reconstruction and the prevailing attitudes toward its treatment, we surveyed the directors of Sports Medicine Fellowship programs about their practices in treating and preventing this complication. Of the 74 surgeons surveyed, 61 (82%) responded. These 61 surgeons performed an average of 98 ACL reconstructions yearly; 31 (51 %) routinely used a drain after ACL surgery, 18 (30%) had treated an ACL infection within the past 2 years, and 26 (43%) had treated an infection within the past 5 years. There was no significant difference in the number of infections and the surgeons' case load, graft choice, or method of reconstruction. Fifty-two surgeons (85%) selected culture-specific intravenous (IV) antibiotics and surgical irrigation of the joint with graft retention as initial treatment for the infected patellar tendon autograft, and 39 (64%) chose this regimen to treat the infected allograft. For the resistant infection unresponsive to initial treatment, IV antibiotics with surgical irrigation and graft retention were also selected as the most common treatment combination for 25 (39%) of the 61 respondents. After graft removal, the earliest a revision procedure would be considered was 6 to 9 months. The results of this survey confirm the widely held belief that septic arthritis of the knee is a relatively rare complication following ACL reconstruction. Once an infection is encountered, culture-specific IV antibiotics and surgical joint irrigation with graft retention are recommended as initial treatment. Graft excision and hardware removal is considered only for those infections resistant to initial treatment and for the infected allograft.
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PMID:Septic arthritis of the knee following anterior cruciate ligament reconstruction: results of a survey of sports medicine fellowship directors. 978 67

Septic arthritis is a serious pyogenic infection that may lead to permanent orthopedic sequelae. Infants represent the most of the cases. It usually develops as a result of bacterial seeding into the capillary-rich synovium in the course of a bacteremic episode. Etiology changes according to different ages; in children after the neonatal period but younger than 24 months, Haemophilus influenzae is the most frequent causative organism. A case of sepsis due to Haemophilus influenzae type b (Hib) with septic arthritis in a patient 3 months old, is reported. The child was admitted to the hospital with a very high temperature (39 degrees C) for five days. His right wrist and ankle appeared swelling and hyperemic. He was affected by congenital cardiopathy from birth. He was not immunizated against Hib. The blood colture was positive for Hib. The leukocyte count was 21,400 cell/mm3 with 55% of polymorphonuclear cells. During the second day of recovery, the patient was transfused, because of the very low value of hemoglobin (5.2 g/dl). The child was treated with netilmycina and ceftriaxone for 15 days. The temperature fell in two days. The articular pathology resolved in nearly ten days. The case reported confirms the importance of septic arthritis as a pathology that necessarily requires an early diagnosis and treatment. The Haemophilus influenzae vaccine, is recommended especially in immunocompromised or cardiopathic subjects and before the age of 2 years.
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PMID:[Sepsis caused by Haemophilus influenzae type B with septic arthritis in an infant]. 984 17

The microbial aetiology of large joint sepsis is changing now that joint replacement therapy is becoming common place. The clinical history and examination may give important clues about the likelihood of infection and the possible involvement of unusual organisms. Newly introduced technology to improve the sensitivity of tests for the presence of micro-organisms in synovial fluid has not yet made a significant contribution to routine management. New imaging techniques such as magnetic resonance imaging are likely to improve patient management, but their utility is still under assessment. Arthroscopic biopsy to obtain material for culture and histology is particularly important in suspected chronic septic arthritis. Prosthetic joint infections present a particular challenge to microbiologists since the organisms involved are often found in small numbers and are common skin contaminants. Optimal microbiological management involves the taking of multiple (> or = 5) samples, careful processing to resuscitate organisms whilst avoiding contamination, and careful interpretation of results in the light of the clinical and histological picture.
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PMID:The diagnosis of large joint sepsis. 986 17


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