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)

Four non-Chinese patients, middle-aged or older, developed agranuloctyosis while taking Chinese herbal medicines for relief of arthritis and back pain. All four developed life-threatening infections with bacterial sepsis; one died. The herbal medicines were shown to contain substantial amounts of undeclared aminopyrine and phenylbutazone, drugs that are well-known causes of agranulocytosis. These Chinese herbal medicines are widely available over the counter throughout the United States.
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PMID:Agranulocytosis caused by Chinese herbal medicines. Dangers of medications containing aminopyrine and phenylbutazone. 12 93

A review of 41 patients in whom knee fusion was performed mainly for degenerative arthritis and sepsis disclosed that only 15% of patients were without complications. Complications were numerous and appeared both early and late - persistent knee and back pain were the most common. Many patients were unable to return to work or to participate in social activities. The optimal position for fusion is 15 to 20 degrees of flexion, which results in a smoother gait and less difficulty for the patient in driving a car. Because of the continued refinement in total knee joint replacement, the indications for knee arthrodesis should be confined to the treatment of chronic infection and failed total joint replacement.
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PMID:Knee arthrodesis: long-term results. 127 15

To ascertain the range of neurological problems in patients with systemic cancer, we prospectively evaluated neurological symptoms, neurological diagnoses, and primary tumors in all patients with a history of systemic cancer examined by the Department of Neurology at the Memorial Sloan-Kettering Cancer Center, from Jul 1, 1990, to Dec 31, 1990. Of the 815 patients seen for neurological symptoms, less than half (45.2%) had metastatic involvement of the nervous system. The three most common symptoms were back pain (18.2%), altered mental status (17.1%), and headache (15.4%). The most common neurological diagnosis was brain metastasis (15.9%), followed by metabolic encephalopathy (10.2%), pain associated with bone metastases only (9.9%), and epidural extension or metastasis of tumor (8.4%). Of 133 patients with undiagnosed back or neck pain, 44 (33%) had epidural extension or metastases from tumor and 40 (30%) had pain associated with vertebral metastases only. In 15 (11%) the cause for the back pain was unrelated to metastatic disease. Of 132 patients seen on initial consultation for altered mental status, metabolic encephalopathy was the major neurological diagnosis (80; 61%); 20 (15%) had intracranial metastases. Of 97 patients with undiagnosed headache, 59 (61%) had a nonstructural cause. Fifty-three of these patients had either migraine, tension headache, or headache related to systemic illness (e.g., fever, sepsis). These results indicate that even in patients with systemic cancer, a group particularly prone to developing neurological disease that can be diagnosed radiologically, the role of clinicians remains important in helping distinguish noncancer-related and nonmetastatic neurological problems.
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PMID:The spectrum of neurological disease in patients with systemic cancer. 163 35

Autosomal dominant polycystic kidney disease (ADPKD) is the commonest hereditary nephropathy. We collected 92 cases in VGH. Diagnosis was confirmed by intravenous pyelogram, renal sonogram, or renal CAT scan. The incidence of having positive family history was just only 28.3%. Patients were diagnosed at the mean age of 54 +/- 11 years (26-74 years). The common clinical findings were hypertension (73.9%), abdominal mass, proteinuria, anemia, azotemia, abdominal or back pain and pyuria in orders. Hypertension might present in the early stage with normal renal function (near 40%). Polycystic liver was the major extrarenal lesion (57.6%), but the incidence of abnormal liver function was only 10.1%. Enlarged kidneys were not always palpable, even at end stage of renal function (mean age 56 +/- 9 years, 89.4% kidney palpable). Patient's urine amount was usually nonoliguric, even in uremic stage (82.9%). Sepsis was the first cause of death. Cardiovascular disease and uremia were followed in sequence. Their expired mean age was 61 +/- 7 years (53-74 years).
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PMID:[Autosomal dominant polycystic kidney disease clinical analysis in VGH--Taipei]. 217 45

The presentation and outcome of 61 cases of nontuberculous spinal osteomyelitis were reviewed. Although the commonest presentation was subacute, with back pain predominating, 10% had septicaemia and 7% paraperesis or paraplegia. Most infections were caudal to the fourth thoracic vertebra. One third were associated with preceding urinary, respiratory, dental or abdominal sepsis. Staphylococcus aureus was the infecting organism in 85% of isolates. Delay in diagnosis was frequent. There were four deaths, and seven individuals remained severely disabled: outcome was otherwise satisfactory. An algorithm for the investigation and management of this uncommon but serious condition is proposed.
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PMID:Pyogenic spinal osteomyelitis: a review of 61 cases. 345 13

During a 20 year period at the Johns Hopkins Medical Institutions, 17 patients were operated on for secondary aortoenteric fistula. The interval from initial operation to the onset of symptoms varied greatly and averaged 2.8 years. Symptoms included not only gastrointestinal bleeding but also sepsis and abdominal or back pain. Associated advanced cardiovascular disease was common. Helpful preoperative diagnostic studies included esophagogastroduodenoscopy, aortography, barium contrast gastrointestinal series and groin sinography. However, a high index of suspicion was the most important element of diagnosis. Overall operative mortality was high (47 percent). All six patients with a graft left in the retroperitoneum had an unsatisfactory result (four instances of recurrent aortoenteric fistula). Successful repair was accomplished only in those patients undergoing graft excision and axillofemoral bypass.
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PMID:Secondary aortoenteric fistula. A 20 year experience. 697 90

The diagnosis of vertebral osteomyelitis is easily missed, particularly for the elderly in whom signs of sepsis may not manifest. The case records of 20 patients with vertebral osteomyelitis who were treated at our hospital between January 1989 and April 1993 were reviewed. The average age of the patients was 72 years. Infection was most commonly due to intravenous cannula-related sepsis. Eighty-five percent of patients presented with back pain, and only 30% had a fever. Computerized tomography and magnetic resonance imaging were the most useful radiological investigations; nuclear scanning was sensitive but insufficiently specific. Staphylococcus aureus was the infecting organism in 13 of 16 patients whose microbiological diagnosis was made by blood or bone cultures. Six (45%) of these 13 patients were infected with methicillin-resistant S. aureus (MRSA). Nosocomial infection occurred in 12 (60%) of the patients studied, including all patients with MRSA infections. Vertebral osteomyelitis may be largely preventable if infection-control aspects of intravenous cannulation are improved, attempts at reducing and preventing MRSA colonization are made, and therapy for bacteremias is optimized.
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PMID:Pyogenic vertebral osteomyelitis: analysis of 20 cases and review. 774 37

The fat embolism syndrome is an uncommon clinical disorder that typically occurs as a complication of severe trauma. We report the case of a 60-year-old single-lung transplant recipient who died of massive fat emboli. Before lung transplantation, the patient had been treated with corticosteroids for at least 1 year because of chronic obstructive pulmonary disease caused by centrilobular emphysema and asthmatic bronchitis. After receiving his lung transplant, he was treated with triple-drug immunosuppression, which included 25 mg of prednisone per day. He was discharged from the hospital 2 months after transplantation only to be readmitted 2 weeks later with cytomegalovirus pneumonia, from which he recovered. Concomitantly, he had new lumbar compression fractures with severe back pain and lost approximately 3 cm in height during a 3-week period. On the eleventh day after hospital readmission, he suddenly had a "sepsis-like" illness without a known infectious cause, numerous petechiae and ecchymoses, marked pulmonary edema with worsening diffuse pulmonary infiltrates, profound hypoxemia, decreased mentation, and mild thrombocytopenia. He died 3 days later. With the exception of a positive sputum culture for cytomegalovirus, all cultures were negative. The postmortem examination showed severe osteoporosis, multiple vertebral compression fractures, and widespread massive fat emboli. This is the first reported case of fat emboli as the cause of death in a lung transplant recipient, and the case suggests that the fat embolism syndrome should be considered in the differential diagnosis of a sepsis-like illness in patients who have received steroids during a long period, particularly in the setting of vertebral compression fractures.
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PMID:Fatal fat embolism syndrome after numerous vertebral body compression fractures in a lung transplant recipient. 780 19

Treatment of mycotic aortic aneurysm by excision and extraanatomic bypass is difficult to apply when the infectious process involves the visceral arteries. On the basis of experimental studies in our laboratory that demonstrated prolonged antistaphylococcal activity of rifampin-bonded, gelatin-impregnated Dacron grafts after implantation in the arterial circulation, this conduit was successfully used for in situ replacement of a native aortic infection in two patients. Both patients had fever, leukocytosis, abdominal or back pain, and a computed tomographic scan that demonstrated contained rupture of a mycotic aneurysm. Preoperative computed tomography-guided aspiration and culture of periaortic fluid from one patient grew Staphylococcus aureus. Treatment consisted of prolonged (6 weeks) culture-specific parenteral antibiotic therapy, excision of involved aorta, oxychlorosene irrigation of the aortic bed, and restoration of aortic continuity by in situ prosthetic replacement. A preliminary right axillobifemoral bypass was performed in the patient who had an infection involving the suprarenal and infrarenal aorta. In both patients intraoperative culture of aorta wall recovered S. aureus. Patients were discharged at 20 and 21 days. Clinical follow-up and computed tomographic imaging of the replacement graft beyond 10 months after surgery demonstrated no signs of residual aortic infection. In the absence of gross pus and frank sepsis, the use of an antibiotic-bonded prosthetic graft with antistaphylococcal activity should be considered in patients who have arterial infections caused by S. aureus when excision and ex situ bypass are not feasible.
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PMID:In situ repair of mycotic abdominal aortic aneurysms with rifampin-bonded gelatin-impregnated Dacron grafts: a preliminary case report. 880 70

Five patients, aged between 64 and 75 years with Salmonella-infected abdominal aortic aneurysms were surgically treated between 1993 and 1995 at the National Cheng Kung University Hospital. Cultures of aneurysmal wall tissue and blood yielded Salmonella enteritidis Group B in three patients and Salmonella choleraesuis in the remaining two. All patients presented with fever and abdominal or back pain. Pulsatile masses were noted in only two patients. Infrarenal abdominal infected aneurysms were demonstrated by computed tomography and aortography in each patient. The five patients underwent aneurysmal resection with in situ graft reconstruction from 1 to 20 days after the diagnosis was made. The graft was wrapped with an omental pedicle. Duodenal repair was performed in one patient due to an aortoduodenal fistula found during surgery. He died 19 days after surgery because of duodenal leakage and uncontrolled sepsis. Four patients survived and remained well 11 to 34 months (mean, 25 mo) after surgery. Postoperatively, only one patient developed adhesion ileus and required enterolysis. Parenteral antimicrobial therapy was continued in all patients after surgery for 2 to 4 weeks; only one patient had an additional 4 months of oral antibiotics. Although the number of patients was small, the survival rate was high, at 80%. Our experience suggests that Salmonella-infected aneurysms of the abdominal aorta can be successfully treated by resection of the aneurysm with extensive debridement followed by in situ graft interposition with omentum wrapping. Once diagnosed, the patients should be scheduled for surgery as soon as possible. Antibiotics should be continued parenterally for at least 2 to 4 weeks postoperatively. While long-term suppressive antibiotic therapy is usually recommended, it might not be essential with our surgical approach.
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PMID:Surgical experience with Salmonella-infected aneurysms of the abdominal aorta. 917 Aug 22


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