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)

We describe the first recorded case of segmental mediolytic arteritis (SMA) in Japan. A 71-year-old Japanese woman developed sudden abdominal pain and went into shock during hospitalization for treatment of valvular heart disease. Laparotomy revealed a ruptured pseudoaneurysm of the left gastric artery. Histological examination of the resected artery revealed multiple extensive areas of the dilated wall where the media had partially or totally disappeared with or without the intima. These features were typical of those described previously for SMA (1,2). Three-dimensional analysis of the arterial lesions revealed that the residual media formed branches and cavities down the long axis of the artery, indicating that the major cause of the medial disappearance was arterial dissection. Three months later, the patient died of sepsis. Autopsy revealed pseudoaneurysm formation at three different locations in the splenic artery. Histologically, these pseudoaneurysms showed destructive changes in the arterial wall similar to those described above, with organization and thrombosis, and were considered to be the end-stage lesion of SMA. This case is considered to be the fifth adult case of SMA in the literature and the first one showing chronic changes.
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PMID:Segmental mediolytic arteritis. Clinicopathologic study and three-dimensional analysis. 157 Jul 42

This report describes the mortality in 100 liver resections performed in 96 patients for seven benign and 93 malignant liver tumours. Repeat hepatectomy was performed in four patients who developed recurrences after the first liver resection. Two patients died within 30 days. The first was a 67-year-old man who died on the 2nd postoperative day from cardiac failure. The second was a 69-year-old man who died on the 4th postoperative day with liver failure caused by hepatic vascular ischaemia. There were four other hospital deaths at days 33, 40, 45 and 50. A 65-year-old lady died on day 40 from sepsis caused by small bowel infarction. A 30-year-old man died on the 33rd postoperative day owing to liver failure from accelerated hepatic lymphoma spread. A 71-year-old diabetic lady died on the 45th postoperative day from sepsis caused by an untreated subphrenic abscess. A 65-year-old lady died on day 50 from systemic candidiasis after adult respiratory distress syndrome (ARDS). Further reduction in operative mortality could be achieved by better patient selection. Liver resection still remains a major operation, but has become a safe surgical procedure.
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PMID:Early mortality in 100 consecutive liver resections in 96 patients with benign and malignant liver tumours. 779

We report here a case of Cogan's syndrome associated with systemic vasculitis as well as myeloperoxidase-specific antineutrophil cytoplasmic antibody (MPO-ANCA)-related glomerulonephritis. A 71-year-old woman with the diagnosis of aortitis syndrome and pulmonary fibrosis for 7 years, complained of vertigo and hearing impairment. A diagnosis of serous otitis media was made. Although steroid therapy was effective, the symptoms relapsed several times. Seven months after the first manifestation of aural symptoms, she developed painful red eyes bilaterally and proteinuria. On admission, perinuclear ANCA without cytoplasmic ANCA was detected by indirect immunofluorescence assay and MOP-ANCA was detected by enzyme linked immunosorbent assay using the 363 ELISA Unit. Renal biopsy showed necrotizing crescentic glomerulonephritis without immune deposits. A diagnosis of atypical Cogan's syndrome with systemic vasculitis and pulmonary fibrosis was made from the clinical and histological findings. As nephrotic syndrome progressed after admission, she was started on high-dose corticosteroid administration. Urinary protein and other symptoms, except for hearing acuity, improved in parallel with a decrease in the MPO-ANCA titer to normal values. While tapering the dose of corticosteroid, the MPO-ANCA titer increased again and dyspnea occurred. Although pulse methylpredonisolone therapy was performed, the patient died of respiratory failure complicated with sepsis. Postmortem lung biopsy showed pulmonary fibrosis and massive alveolar hemorrhage. The findings of this case study suggest that MPO-ANCA may be closely related to the pathogenesis of Cogan's syndrome.
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PMID:[A case of myeloperoxidase-specific antineutrophil cytoplasmic antibody (MPO-ANCA)-related glomerulonephritis associated with Cogan's syndrome]. 891 96

We report an autopsy case of reactive hemophagocytic syndrome with peculiar liver histology. A 71-year-old female was diagnosed as having acute myelogenous leukemia and treated with chemotherapy. During her course, methicillin-resistant Staphylococcus aureus (MRSA) was noted in blood culture and she was diagnosed as having MRSA sepsis. She died of respiratory failure 5 months after the onset of leukemia and 10 days after the MRSA sepsis. Ante-mortem liver function tests were within normal ranges. At autopsy, myeloblastic leukemia cells positive for CD13 were present in the bone marrow and, to a much lesser extent, in the spleen and liver. Numerous histiocytes of a bland appearance with erythrophagocytosis were noted in the bone marrow and spleen. The histiocytes were positive for CD68, but negative for S-100 and lysozymes. In the liver, many histiocytes of bland appearance with erythrophagocytosis and CD68 positivity were present in the portal tracts with no Kupffer cell hyperplasia. There were no hepatocellular degeneration, fatty changes or sinusoidal dilations. We consider that this histiocytosis was associated with MRSA infection and diagnosed this as infection-associated hemophagocytic syndrome. In previously reported cases, hemophagocytosis in hyperplastic Kupffer cells was the main liver change of reactive hemophagocytic syndrome. The present case suggests that marked histiocytosis in portal tracts only may be a main feature of liver changes in reactive hemophagocytic syndrome and that such cases may not show abnormal liver function tests.
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PMID:Marked histiocytosis in the portal tract in a patient with reactive hemophagocytic syndrome: An autopsy case. 1050 32

We report a rare case of hypothermia with acute renal failure in a patient suffering from diabetic nephropathy. A 71-year-old male who had been receiving insulin therapy for the treatment of diabetes mellitus complicated with advanced diabetic nephropathy since 1998 was malnourished with an extremely decreased muscle mass. Without any prolonged exposure to excessively low external temperatures or hypothyroidism, pituitary insufficiency, adrenal insufficiency, sepsis, hypoglycemia, and diabetic ketoacidosis, acute hypothermia appeared together with an aggravation of diabetic nephropathy. His skin temperature fell to below measurable levels and his rectal temperature fell to 30.0 degrees C. His consciousness was drowsy and the hypothermia was not accompanied by shivering. Skeletal muscle is known to play an important role as a center of heat production and shivering thermogenesis in skeletal muscle mainly operates on acute cold stress. Therefore, in this case, hypothermia may have occurred because the shivering thermogenesis could not fully act on the acute cold stress due to the dramatically reduced muscle mass. We should always keep in mind that older, malnourished diabetic patients can easily suffer from impairments of the thermoregulatory system.
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PMID:Hypothermia with acute renal failure in a patient suffering from diabetic nephropathy and malnutrition. 1080 30

A 71-year-old woman with an 8-year history of IgG-kappa type multiple myeloma was admitted because of severe lumbago and bone destruction. Her serum IgG level was elevated to 5,565 mg/dl at admission. Despite treatment with doxorubicin, vincristine, dexamethasone, melphalan and interferon-alpha, the response was transient. Nine months later, multiple skin nodules appeared on her chest, abdominal wall and right thigh accompanied by elevation of the serum IgG level. Response to combination chemotherapy with cyclophosphamide, ranimustine, vincristine and prednisolone was also transient. The skin tumors on the bilateral thighs, especially on the left side, acquired chemotherapy resistance and gradually enlarged. Although the serum IgG level was maintained by chemotherapy within the range 1, 790-2,676 mg/dl, the skin tumors on the left thigh had spread very rapidly and appeared "rock-like". The enlarged tumors caused necrosis with erosions and oozing hemorrhage. A skin biopsy from the tumors on the left thigh showed plasmacytoma in which infiltration of large anaplastic plasma cells was observed. The patient died of sepsis 8 months after the skin tumors initially developed. This is a very rare case of multiple myeloma in which multiple large plasmacytomas of the skin developed and grew aggressively at the terminal stage after a long-term indolent course.
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PMID:[Gross spreading multiple extramedullary plasmacytomas to the skin in the terminal stage of multiple myeloma]. 1152 46

A 71-year-old male was diagnosed with a Salmonella dublin infection. He presented with abdominal pain with no diarrhoea, and sepsis, and was found to have an infected aneurysm of the infrarenal abdominal aorta. He was treated surgically with resection of the aneurysm and implantation of an extra-anatomic axillobifemoral bypass, followed by long-term antibiotic treatment. Nine months after the primary treatment, the patient died as a result of rupture of the aortic stump. S. dublin-infected aneurysm of the abdominal aorta is a rare condition with high mortality. Human S. dublin infections are associated with the consumption of unpasteurised dairy products from infected animals.
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PMID:[A men with a Salmonella dublin-infected aneurysm of the abdominal aorta]. 1205 24

A 71-year-old man presented with hemoptysis due to chronic contained rupture of the descending thoracic aorta after sepsis by Escherichia coli complicated with transrectal biopsy of the prostate, and underwent urgent graft replacement. The aorta had an almost normal caliber and ruptured into the left lung without abscess. The perforated site of the lung was filled with gelatin-resorcinol-formaldehyde glue, and the defect of the aortic wall was closed. Without graft infection, lung abscess, or sepsis, the patient was discharged followed by 1 month's intravenous administration of cefazolin and piperacillin sensitive to Escherichia coli after the surgery.
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PMID:Chronic contained rupture of the descending thoracic aorta due to infection by Escherichia coli. 1602 72

A 71-year-old man presented with fever and positive blood cultures for methicillin-sensitive Staphylococcus aureus 4 days after an uncomplicated intra-luminal abdominal aortic aneurysm repair. Investigations looking for a source of sepsis including computerized tomography scans, transoesophageal echocardiography, a bone scan and repeated chest X-rays, did not reveal an infective focus. Gallium(67) scintigraphy, however, showed a focus of tracer uptake in the region of the aorto-cardiac junction consistent with the presence of an abscess. Coronary angiography later opacified an aneurysmal cavity arising from the right sinus of Valsalva which was confirmed to be a mycotic aneurysm on thoracotomy. This is a rare case of early detection of a cardiac mycotic aneurysm by Gallium(67) scintigraphy.
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PMID:Mycotic coronary artery aneurysm detected by gallium67 scintigraphy. 1635 78

A 71-year-old female with rheumatoid arthritis and chronic use of corticosteroids presented to the emergency room with 2 weeks of urinary symptoms, abdominal pain and a mass located in hypo-mesogastrium and both flanks. An X-ray film of the abdomen showed that bowels were displaced by the mass. Laboratory studies showed thrombocytosis (549,000/mm(3)) and leukocytosis (41,800/mm(3)). Several hours after her arrival the patient developed acute abdomen and surgery was indicated. A urinary catheter drained 2100 ml of urine and the abdominal mass was reduced in size but did not disappear. Surgery demonstrated that the urinary bladder covered the fundus and the anterior face of the uterus, where extensive necrosis and a 3-cm perforation were found; 400 ml of foul-smelling pus was drained from the uterine cavity. Due to necrosis, a hysterectomy was performed. The histopathological report indicated necrosis, atrophic cervicitis and endometritis; pus culture developed Escherichia coli and Proteus vulgaris. Despite administration of broad-spectrum antibiotics, the patient developed severe sepsis and died 11 days postoperatively. During a literature review, only one similar case was found. Acute abdomen due to uterine perforation secondary to pyometra and associated with chronic use of corticosteroids is a rare complication.
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PMID:[Acute abdomen secondary to spontaneous uterine rupture associated with pyometra]. 1688 87


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