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

Aortic arch mycotic aneurysm, an uncommon cause of sepsis, carries a grave prognosis. Clinical presentations as well as laboratory and radiologic examinations may be noncontributory and often misleading. In a patient with a fever of unknown origin, only the radiogallium study could enable an accurate diagnosis and pinpoint the anatomic localization of the mycotic aneurysm as the cause of fever.
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PMID:Occult aortic arch mycotic aneurysm diagnosed by radiogallium scintigraphy. 142 55

A 24-year-old woman with acquired immunodeficiency syndrome was admitted with septic fever of unknown origin and a 2-week history of diarrhea. Clinical diagnostic procedures did not reveal the cause of sepsis. Broad-spectrum antibiotics and intensive symptomatic therapy could not prevent progressive deterioration. The patient developed septic shock and consumptive coagulopathy and died 6 days after admission. Autopsy revealed disseminated infection with toxoplasma gondii and multiple organ manifestations. We conclude that disseminated toxoplasmosis should be considered in AIDS patients with septic disease of unknown origin. Extremely elevated lactate dehydrogenase may suggest disseminated toxoplasma gondii infection. New procedures such as polymerase chain reaction for detection of toxoplasmosis may be helpful diagnostic tools.
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PMID:Disseminated toxoplasmosis with sepsis in AIDS. 146 32

Fifty-two patients with moderate or severe infections associated with internal medicine were treated with imipenem/cilastatin sodium (IPM/CS) and the efficacy and the safety of this drug were evaluated. There were 20 patients with pneumonia, 10 with acute exacerbation of chronic respiratory tract infections, 9 with sepsis, 2 with pyothorax, 3 with intraabdominal infection, 2 with urinary tract infection, 1 with pulmonary abscess, 1 with infective endocarditis, 4 with fever of unknown origin. Forty-four patients were evaluable for the efficacy. Clinical efficacies were excellent in 12 patients, good in 26, fair in 3 and poor in 3. The overall clinical efficacy was 86.4%. The efficacy rate was 63.6% in patients previously treated and 93.9% in patients previously untreated with other antibiotics. Bacteriologically, Staphylococcus aureus (8 strains), Streptococcus pneumoniae (5), Streptococcus pyogenes (1), other Gram-positive coccus (1), Klebsiella pneumoniae (8), Haemophilus influenzae (4), Pseudomonas aeruginosa (3), Serratia marcescens (3), Escherichia coli (3), Branhamella catarrhalis (1), Citrobacter freundii (1), Klebsiella oxytoca (1), Enterobacter sp. (1), and Peptostreptococcus sp. (1) were eradicated. P. aeruginosa (3) and Acinetobacter sp. (1) decreased. S. aureus (1), S. epidermidis (1), P. aeruginosa (5), and S. marcescens (1) persisted or appeared. The eradication rate was 83.7%. Six patients showed adverse reactions including general fatigue 1, epigastralgia 1, eruption 1, eosinophilia 1 and elevation of S-GOT 2. But all of the adverse reactions were mild or slight, and transient. These findings indicate that IPM/CS is a useful and safe drug against bacterial infections in internal medicine.
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PMID:[Clinical evaluation of imipenem/cilastatin sodium in the internal medicine]. 192 Aug 13

The effectiveness of sulbactam/cefoperazone (SBT/CPZ) on severe infections associated with hematological diseases was evaluated in a nation-wide multicenter clinical study. SBT/CPZ (4-6 g/day), a 1:1 combination of SBT and CPZ, was given intravenously to 437 patients with hematological disorders. The underlying diseases included acute nonlymphocytic leukemia, acute lymphocytic leukemia, malignant lymphoma, multiple myeloma, myelodysplastic syndrome and others. Thus, 94.3% of the patients had hematological malignancies. The complicating infections included sepsis in 41 cases; sepsis suspected in 205; pneumonia in 47; urinary tract infection in 15; fever of unknown origin in 59; and others in 70. Clinical efficacies of SBT/CPZ were as follows; markedly effective, 83 cases; effective, 170; fairly effective, 59; and ineffective, 110. The efficacy rate (markedly effective plus effective) was 60.0% as a whole. The efficacy rate of SBT/CPZ in sepsis and suspected cases, which accounted for 56.3% of the infections, was 59%. Mild side effects such as skin rash were observed in 15 patients (3.1%). As for abnormal laboratory test results, transient increases in GOT, GPT, A1-P, LDH, etc. were observed in 42 patients (8.6%). Therefore, SBT/CPZ is considered to be a useful drug in empiric therapy for severe infections associated with hematological diseases.
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PMID:[Clinical evaluation of sulbactam/cefoperazone for severe infections associated with hematological disorders]. 196 Aug 59

We report on the rare association of Hodgkin's disease with systemic lupus erythematosus. Two years after the diagnosis of systemic lupus erythematosus, the patient developed upper abdominal pain, jaundice, splenomegaly, and fever of unknown origin. He had a rapidly fatal clinical course, despite being treated for systemic lupus erythematosus, cholecystitis, and possible sepsis. Autopsy revealed Hodgkin's disease, lymphocyte-depletion type, involving lymph nodes, liver, spleen, and bone marrow. The awareness of the association of Hodgkin's disease with systemic lupus erythematosus and its modes of presentation will help in the early diagnosis and management of such patients.
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PMID:Hodgkin's disease associated with systemic lupus erythematosus. 205 Mar 74

Technetium (99mTc) labelled, polyclonal human immunoglobulin (HIG) is a new agent that detects focal infection and inflammation. This new agent was compared in 40 patients with the accepted standard, namely 111In-oxine-labelled leucocytes. This comparison resulted in a sensitivity of 94% and a specificity of 96% for 99mTc-HIG when 111In-oxine leucocytes were defined as giving the true result. The new agent was shown to localize both sepsis and active inflammatory bowel disease (IBD). There was 100% concordance in the 16 patients with IBD who were imaged with both 99mTc-HIG and 111In-oxine leucocytes. Discordant results were obtained in one case of suspected osteomyelitis, which was false-positive on the 99mTc-HIG scan, and one case of pyrexia of unknown origin when the 99mTc-HIG was false-negative and the 111In-oxine leucocyte scan demonstrated accumulation of tracer in the caecum at 24 h post-injection. Normal distribution for 99mTc-HIG demonstrated activity in the kidneys and bladder and that 50% of the tracer is cleared through the kidneys during the first 24 h post-injection. There were no major or minor side-effects.
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PMID:99mTc-human immunoglobulin (HIG)--first results of a new agent for the localization of infection and inflammation. 211 69

We report an analysis of the results obtained in our first 100 studies with indium-111-oxine labelled leukocyte scintigraphy, a diagnostic technique which has recently become available for clinical evaluation within Australia. We used this technique to assess patients with suspected sepsis or inflammation after other commonly used investigations had failed to confirm a diagnosis. Four patient subgroups were evaluated: fever of unknown origin; suspected abdominal or postoperative sepsis; suspected active inflammatory bowel disease; and suspected sepsis or inflammation of bones or joints. The course of all patients was followed for at least three months to establish the accuracy of the technique. The leukocyte labelling procedure took 90 min and imaging was carried out typically 3-6, 24 and occasionally 48 h after reinjection of the labelled autologous leukocytes. In one patient labelling of leukocytes was unsuccessful. In the remaining 99 studies the overall sensitivity of leukocyte scintigraphy was 88% (36 of 41 patients with a proved inflammatory or infective disease focus had positive scan findings); and the specificity was 95% (55 of 58 cases with no proved disease focus had normal scan findings). This series supports the use of this method as the imaging procedure of choice in nuclear medicine for the evaluation of suspected acute sepsis (symptoms less than four weeks' duration), of inflammatory bowel disease and of suspected infections involving appendicular bones which contain no active bone marrow. It is also a useful secondary scintigraphic procedure, after gallium-67-citrate scintigraphy, in patients with suspected infective disorders of more than four weeks' duration.
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PMID:111In-oxine labelled leukocyte scintigraphy in the detection and localization of active inflammation and sepsis. 209 96

Listeria monocytogenes, an uncommon perinatal infection in human, has been reported to be correlated with abortion, premature labor, intrauterine fetal sepsis, intrauterine fetal death and neonatal infections. Reported here was the first case of perinatal listeriosis complicated with Listeria monocytogenes chorioamnionitis at 33 weeks' gestation in Taiwan. The transabdominal amniocentesis in this particular case confirmed the diagnosis. An live premature male fetus was delivered by emergency cesarean section on the next day of hospitalization due to acute fetal distress. The acute ill baby developed signs of meningitis on the following day. Blood culture of Listeriosis monocytogenes indicated early onset neonatal listeriosis. Brain sonography showed hydrocephalus after a one-month period antibiotic treatment, he was lost to follow-up one month later. A review of the literature is presented to describe the clinical, epidemiological and pathological findings and to highlight their variable presentations and procedures for management. Thus it is of great importance for obstetricians to include listeriosis as a differential diagnosis in cases of fever of unknown origin during pregnancy. Promptly obtaining proper cultures and instituting appropriate antibiotics therapy is emphasized.
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PMID:[Perinatal listeriosis--a case report]. 222 8

Indium-111-labeled white blood cell scanning is often used in the investigation of pyrexia of unknown origin (PUO) to locate an otherwise occult source of sepsis. From a series of 166 white blood cell studies performed for sepsis, 28 cases of true PUO were identified and reviewed. The sensitivity was 60% and specificity 70%, with a positive predictive value of 38% and negative predictive value of 90%. Only 11% of studies revealed a pyogenic cause for PUO. These results are discussed and the potential role of gallium scanning in PUO is raised.
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PMID:The role of indium-labelled leukocyte imaging in pyrexia of unknown origin. 225 77

Among infections in leukemia patients during their first induction treatment pneumonia was the third most frequent infection (11.4%) following fever of unknown origin and sepsis. Granulocytopenia was suggested to be very closely related to the onset of pneumonia. Laminar air flow rooms seemed very effective for preventing exogenous infections including pneumonia. They reduced pneumonia from 30 to 0 in 106 patients with acute leukemia during their first induction treatment. Bone marrow transplantation (BMT) is one of the most intensive immunosuppressive treatments. Major causes of failure were interstitial pneumonitis (IP) due to cytomegalovirus (CMV), relapse of leukemia and bacterial and fungal infections. The incidence of IP was reduced by fractionation of total body irradiation and selection of CMV antibody negative donor for platelet transfusion. Administration of anti CMV immunoglobulin has also reduced the incidence of IP significantly from 37.5% to 11.5%. Colony stimulating factor appeared to stimulate the recovery of leukocytes after BMT. By several modifications of BMT techniques, mainly for the prevention of infection and IP, the survival of patients after BMT has improved significantly from 20% to 85%. In conclusion, prevention and treatment of respiratory infections are important in the treatment of leukemia, both for chemotherapy and BMT.
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PMID:[Prevention and treatment of respiratory infections in leukemia patients]. 261 86


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