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

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

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

The role of gastric mucus in the pathogenesis of septic erosions and as an explanation for prostaglandin cytoprotection is unclear. In a reproducible canine septic model bacterial peritonitis was induced in three groups of dogs. One group served as a control and each of the remaining groups received 16,16 dimethyl PGE2 either 0.2 microgram/kg. or 0.4 microgram/kg. I.M. q6h beginning 24 hours prior to peritonitis and continued during the septic period. Gastroscopy was performed and basal gastric juice collected prior to peritonitis and during the septic period. All animals in the control group developed acute gastric erosions and gastric juice protein significantly decreased while sialic acid and fucose significantly increased during the septic period. In the animals receiving 16,16 dimethyl PGE2 acute gastric erosions did not develop; sialic acid and fucose were significantly elevated compared to control dogs during sepsis. We conclude that prostaglandin cytoprotection may be related to increases in gastric glycoprotein secretion.
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PMID:The role of mucus glycoproteins in prostaglandin cytoprotection. 742 69

The cytoprotective and acid-inhibitory effects of cimetidine and 16,16-dimethyl PGE2 were evaluated in a septic canine erosive gastritis model. In 21 dogs, total gastric fistulas were created, and after a 3-wk recovery period, basal, food-, and pentagastrin-stimulated acid output were measured. Then bacterial peritonitis was created by the intraperitoneal instillation of Pseudomonas, Bacteroides, Streptococcus Fecalis, Klebsiella and canine gallbladder bile. In 5 dogs no drug were given throughout the septic period while in 16 dogs either cimetidine, 6 or 12 mg/kg i.m. every 6 h, or 16,16-dimethyl PGE2, 0.2 or 0.4 microgram/kg i.m. every 6 h, was given 24 h before the induction of peritonitis and continued for 3 days. All 21 dogs had positive blood cultures on the 1st septic day. In the control animals, basal, food-, and pentagastrin-stimulated acid output significantly increased during the first 2 septic days, and gastroscopy demonstrated bleeding acute fundic erosions. Cimetidine decreased basal, food-, and pentagastrin-stimulated acid output in a dose-related manner, and only with the higher dose did it prevent gastric mucosal damage. 16,16-Dimethyl PGE2, 0.4 microgram/kg, significantly decreased acid output and prevented gastric mucosal damage. 16,16-Dimethyl PGE2 0.2 microgram/kg, although having no apparent effect on basal, food-, and pentagastrin-stimulated acid output, prevented the development of acute gastric erosions. Thus, in the canine septic model, acid output significantly increases during sepsis. Cimetidine prevents the development of sepsis-induced gastric erosions by inhibition of acid secretion and 16,16-dimethyl PGE2 by cytoprotection.
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PMID:Prevention of sepsis-induced gastric lesions in dogs by cimetidine via inhibition of gastric secretion and by prostaglandin via cytoprotection. 745 Apr 26

Postsplenectomy bacterial sepsis may be fatal, due to defects in both cellular and humoral immune responses. The objective of this study was to assess the efficacy of peritoneal macrophage antibacterial function in the early postsplenectomy period. Murine models of splenectomy and sham operation were characterized and peritoneal macrophages were harvested 24 h to 1 wk after surgery. Cells from splenectomized animals demonstrated a nonsignificant delay in phagocytosis of Escherichia coli at 24 h with, however, significantly impaired killing of intracellular organisms at 24 h and 1 wk compared to the sham group. Paradoxically, the production of the macrophage antibacterial product superoxide anion was not impaired at either time point in the splenectomy group compared with sham-operated and control mice. Nitric oxide release was significantly lower in the splenectomized group (p = 0.006), a possible explanation for reduced bacterial killing. Mortality from bacterial peritonitis was significantly higher with concomitant splenectomy than in the sham splenectomy group at 24 h (p < 0.02). The production of TNF from macrophages was up-regulated immediately following splenectomy, a cytokine which may contribute to mortality from bacteremic shock. Local defects in macrophage antimicrobial function may contribute significantly to bacteremia and to subsequent mortality in the early postsplenectomy period.
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PMID:Characterization of the defects in murine peritoneal macrophage function in the early postsplenectomy period. 760 13

Fifty-nine episodes of bacteremia due to Aeromonas species occurred within a 5-year period in one medical center in southern Taiwan. Underlying diseases in the 58 patients included hepatic cirrhosis (36%) and cancer (24%). Patients with aeromonas bacteremia more often had underlying hepatic cirrhosis than did those with bacteremia due to other gram-negative bacilli. Males (67%) outnumbered females. The cases appeared to cluster in the summer and fall months. Thirty-two percent were polymicrobial infections; often the Aeromonas pathogens were accompanied by other gram-negative bacilli. Aeromonas hydrophila was the most common species isolated (69%). In addition to fever, hypotension and jaundice were the common clinical manifestations of aeromonas sepsis. In cirrhotic patients, spontaneous bacterial peritonitis, altered mental status, and jaundice were most common, and aeromonas bacteremia in such patients was monomicrobial and community-acquired more often than in noncirrhotic patients. In vitro aeromonads were generally susceptible to aminoglycosides, cefuroxime, the third-generation cephalosporins, and quinolones. The overall crude fatality rate was 36%. Predictors of fatal outcome for cirrhotic patients included spontaneous bacterial peritonitis, hypotension on admission, diabetes mellitus, and high Pugh scores.
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PMID:Aeromonas bacteremia: review of 59 episodes. 762 14

Sepsis due to Streptococcus pneumoniae has a high mortality. We report a retrospective review of 40 episodes of S pneumonia sepsis in adult patients during a two year period in a general hospital, that represented 11.3% of all sepsis observed in such hospital. Ninety two percent of infections were community acquired and in 95%, the portal of entry was the respiratory tract. Eighty five percent of patients had at least one risk factor such as alcohol abuse, unconsciousness or chronic pulmonary disease. Nine patients had suppurative complications (empyema in 4 cases, spontaneous bacterial peritonitis in 2, septic arthritis in 2 and meningitis in 1 case) and 12 (30%) died. The potential benefit of antipneumococcal vaccine as prevention should be considered in high risk subjects.
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PMID:[Streptococcus pneumoniae septicemia. Analysis of 40 cases]. 765 13


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