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Query: UMLS:C0341503 (bacterial peritonitis)
 1,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two patients with alcoholic cirrhosis were seen on two separate occasions for fever, swollen legs, petechial hemorrhage, purpura, and cutaneous bullae. One patient ate oysters 2 days before the onset of illness. Vibrio vulnificus, a lactose-positive halophilic vibrio, was isolated from the ascitic and cutaneous fluid in both cases, and from the blood in one of the two cases. Both isolated strains were sensitive to the antibiotics given to the patients from the beginning; however, both patients died, one from septicemic shock and the other from massive esophageal variceal hemorrhage. Autopsies in both patients revealed alcoholic cirrhosis, hemorrhagic necrosis of the terminal ileum, intraalveolar hemorrhage, petechial hemorrhage in the peritoneum, and nonspecific acute inflammation of the dermis with vasculitis. Physicians should consider V. vulnificus in the differential diagnosis of cirrhotic patients with sepsis, primary skin lesions, and spontaneous bacterial peritonitis with or without history of recent oyster ingestion.
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PMID:Spontaneous Vibrio vulnificus peritonitis and primary sepsis in two patients with alcoholic cirrhosis. 389 20

Acute abdomen, irreversible shock and sudden death are a typical although infrequent complication in patients with hemochromatosis. The author presents a further case of this syndrome and discusses the two leading pathogenetic interpretations described in the literature: sudden release of ferritin, and endotoxin shock. Clinical and post-mortem findings from this patient and a review of 19 cases from the literature suggest that most patients with this syndrome die from a primary bacterial peritonitis with gram negative sepsis and endotoxin shock.
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PMID:[Acute abdomen with irreversible shock, a rare but typical complication of hemochromatosis]. 390 80

To characterize some of the remote effects of systemic sepsis on the lung, we evaluated changes in pulmonary microvascular fluid flux before and during sepsis secondary to a peritoneal focus of inflammation in sheep. We induced peritonitis by cecal ligation, perforation, and devascularization. During a subsequent 72-hour study period, both the mean blood pressure and the pulmonary capillary wedge pressure were unchanged, while the cardiac index increased slightly. The PaO2 fell by 48 hours (98 +/- 8 to 84 +/- 10 mm Hg; p less than 0.05) (mean +/- SD) and subsequently remained low throughout the experiment. Simultaneously, pulmonary lymph flow increased by 24 hours (11.5 +/- 4.9 to 26.7 +/- 13 ml/hr; p less than 0.05) and remained elevated throughout the experiment while [L/P] total protein ratios remained unchanged at 24 hours (baseline: 0.59 +/- 0.15 at 24 hours: 0.65 +/- 0.16). Morphologic examination of the lung showed that this model of peritonitis was characterized by neutrophil emigration into the pulmonary interstitium by 24 hours and interstitial edema by 48 hours. Therefore this model of bacterial peritonitis in sheep demonstrates that one of the remote effects of surgically induced systemic sepsis is an increase in permeability of the pulmonary microvascular membrane.
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PMID:Pulmonary microvascular fluid flux in a large animal model of sepsis: evidence for increased pulmonary endothelial permeability accompanying surgically induced peritonitis in sheep. 394 25

We studied the functional effects of intraperitoneal sepsis on systemic hemodynamics in general, and on renal function in particular, in sheep in whom bacterial peritonitis was induced by cecal perforation. In the first group of seven sheep (group 1) fluid was administered throughout the period of sepsis to maintain pulmonary capillary wedge pressure as close to presepsis values as possible. These sheep exhibited hemodynamic changes known to be associated with sepsis in man: increased cardiac output and decreased systemic vascular resistance. In a second group of seven sheep (group 2) fluid intake was restricted; compared with group 1, these sheep demonstrated a smaller increase in cardiac output that did not persist and that was associated with an increase in the systemic vascular resistance during the septic period. Plasma renin levels increased fivefold in group 2 but were unchanged in group 1. Serial renal biopsies during the septic period revealed that all sheep had evidence of tubular cell damage on electron microscopy: cell swelling, loss of the microvillous brush border, and cell necrosis. Both groups of sheep also demonstrated marked tubular proteinuria similar to that found in humans with generalized sepsis. Despite this, sheep in group 1 exhibited no functional renal changes: creatinine clearance levels rose slightly from control values, urine concentrating ability was unimpaired, and fractional excretion of sodium increased appropriately in response to a sodium load. In contrast, group 2 sheep exhibited a fall in creatinine clearance levels but fractional sodium excretion did not fall as would have been expected were renal function entirely normal. The results suggest that generalized "hyperdynamic" sepsis induces tubular cell damage and tubular proteinuria by an unknown mechanism. However, this does not necessarily produce renal impairment since the glomerular filtration rate does not fall unless volume contraction is also allowed to occur.
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PMID:Renal and cardiovascular response to nonhypotensive sepsis in a large animal model with peritonitis. 396 24

A case of Pasteurella multocida septicemia and peritonitis in a patient with cirrhosis is reported and the literature reviewed. Patients with cirrhosis and exposure to domestic animals are at risk for this infection. Initial empiric therapy of spontaneous bacterial peritonitis in such patients should include a penicillin to which this organism is usually susceptible.
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PMID:Pasteurella multocida septicemia and peritonitis in a patient with cirrhosis: case report and review of the literature. 401 8

Spontaneous bacterial peritonitis, due to Capnocytophaga ochracea, developed in a 65-year-old alcoholic patient with extensive cirrhosis and ascites. Previously reported human infections with this organism have included peridontal diseases, septicemia, and arthritis. This is the first report of spontaneous bacterial peritonitis associated with Capnocytophaga species.
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PMID:Peritonitis involving Capnocytophaga ochracea. 402 64

Bacterial peritonitis, intraabdominal sepsis, and other surgical infections are frequently polymicrobial. Moxalactam, a new beta-lactam antibiotic, has been shown to be active in vitro against most bacterial pathogens commonly isolated from patients with surgical infections. This drug was therefore tested as the sole antimicrobial agent in the treatment of 32 surgical infections (25 cases of intraabdominal sepsis, 6 cases of wound infections, and 1 case of bacteremia). Nearly all (91%) of the infections responded favorably; 66% were cured with moxalactam plus surgery, 16% were cured with moxalactam alone, and 9% improved. Moxalactam-resistant strains of bacteria were isolated from 18 infections but were associated with therapeutic failure in only two cases and with superinfection in three cases. On the basis of these data, we believe that moxalactam is an effective and safe antimicrobial agent for use alone in the treatment of serious intraabdominal infections.
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PMID:Moxalactam in the treatment of intraabdominal sepsis and other surgical infections. 621 82

We present our experience with performing an exploratory laparotomy for peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Six of 134 patients undergoing CAPD during the study period underwent surgical intervention because of abdominal sepsis. Two patients had bacterial peritonitis without abscess formation or evidence of visceral perforation and they recovered readily and, in retrospect, may not have required an operation. Of the three patients with fungal abscesses, two died of subsequent bacterial sepsis, while one patient survived, albeit after drainage of a recurrent pelvic abscess. One patient died because of extensive intestinal gangrene that was misdiagnosed as CAPD-related peritonitis initially. Our experience with these cases suggests that fungal peritonitis is a life-threatening complication that may result in both formation of an abscess and death. Therefore, it warrants aggressive antifungal chemotherapy and surgical intervention should an abscess be discovered. In contrast, bacterial peritonitis should be treated with appropriate antibiotic regimens until adequate evidence indicating the presence of a surgical condition is obtained.
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PMID:Ambulatory peritoneal dialysis. Exploratory laparotomy for peritonitis. 639 19

The septic complications of peptic ulcer perforation have not been adequately described in the literature because the sparse microflora usually present in the upper gastrointestinal tract is generally believed to represent a minimal risk. One hundred and eighty-two peptic ulcer perforations (150 duodenal, 32 gastric), seen over 15 years, are reviewed. The septic complications relating to intestinal perforation included intra-abdominal abscess (22 cases), wound infection (26 cases) and generalized bacterial peritonitis (18 cases). The incidence of postoperative abscesses was significantly (p less than 0.05) greater in patients with gastric than with duodenal perforation. In both groups, abscesses were much more frequent when perforation occurred more than 24 hours before operation. The risk of intra-abdominal sepsis following acute peptic perforation is substantial. In such cases, routine anaerobic and aerobic cultures should be done of fluid taken from the peritoneal cavity at operation.
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PMID:Septic complications of perforated peptic ulcer. 686 Oct 36

Ecthyma gangrenosum caused by Escherichia coli (E. coli) occurred in a decompensated alcoholic cirrhotic patient with spontaneous bacterial peritonitis due to the same organism. Ecthyma is usually associated with systemic sepsis from Pseudomonas aeruginosa. Isolated instances due to other bacteria have been reported, but its occurrence in spontaneous bacterial peritonitis, of which the predominant causative organism is E. coli, is unique. The frequency, varied etiology, and pathogenesis of ecthyma are briefly reviewed.
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PMID:Spontaneous bacterial peritonitis with ecthyma gangrenosum due to Escherichia coli. 704 96


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