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

Total amylase concentration in serum continues to be widely determined in the diagnosis of acute pancreatic disease. Accumulated experience has made clear, however, that this determination has distinct limitations. Consequently, the knowledge of the origin of hyperamylasemia may have an important influence on treatment, hospitalization, and extent of clinical investigations. We undertook a logical and systematic approach to the interpretation of hyperamylasemia through the use of an algorithm that can be applied in clinical situations without the need for the integration of radiologic procedures or clinical data. The proposed algorithm was tested for effectiveness in 97 consecutive hospitalized patients with hyperamylasemia (amylase level greater than twice the upper reference limit) for a 2-year period. The majority (52.5%) of these patients had acute pancreatitis. The algorithm assigned the correct diagnostic categories in 95.8% of cases, with a disagreement between patient diagnosis and algorithm-generated diagnosis in only four cases. These four patients (two with acute biliary disease, one with bacterial peritonitis, and one with chronic renal failure) had pancreatic lipase values greater than five times the upper reference limit, so that the algorithm classified their condition as acute pancreatitis. The clinical trial indicated that the proposed decision tree, which requires only knowledge of biochemical data that are readily available, is useful in the evaluation of elevated amylase activity and facilitates arrival at a definitive diagnosis.
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PMID:Clinical evaluation of an algorithm for the interpretation of hyperamylasemia. 170 63

The resorption from the peritoneum of fluorescein-isothiocyanate-conjugated (FITC) dextran with a mol wt of 10,000 was studied after 6, 15, and 24 h in rats with (1) only laparotomy (LC), (2) bacterial peritonitis (BP), (3) bile-induced acute pancreatitis (AP), (4) acute pancreatitis induced with contaminated bile (AIP), and (5) cerulein administration during acute pancreatitis (CAP). Animals in the AIP and CAP groups had a significantly higher mortality rate at 24 h and higher hematocrit at 6 h, indicating severe disease in these animals. At 6 and 15 h, all groups displayed similar peritoneal resorption. After 24 h, all groups with active inflammation showed significantly higher resorption than laparotomy controls. We conclude that peritoneal resorption as defined is independent of the severity and mode of induction of acute experimental pancreatitis and that it is the same as in bacterial peritonitis.
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PMID:The resorption of FITC-dextran 10,000 from the peritoneum in different modifications of bile-induced acute pancreatitis and in bacterial peritonitis. 172 8

This elderly male with a long history of alcohol abuse presented with an acute pleural trauma and hemopneumothorax, which may have served as the precipitating medical illness for cecal volvulus. He subsequently developed bacterial peritonitis as a complication of his bowel obstruction. It is probable that his pleural cavity was seeded hematogenously via a bacteremia from his peritonitis, thus accounting for the empyema with species typical of bowel flora. Cecal bascule is a type of cecal volvulus that causes intestinal obstruction. Diagnosis is difficult, but a delay in recognition may result in intestinal ischemia, perforation, sepsis, and even death. Cecal ischemia or gangrene cannot always be determined based on physical examination or laboratory findings. Plain films of the abdomen may be helpful, and barium enema has been advocated by some authors. However, laparotomy is often necessary for definitive diagnosis and therapy. While cecal volvulus has not been reported to occur frequently in the elderly, the relatively common occurrence of anatomic predisposition in addition to the widespread use of respirators and the increasing age and number of medical illnesses of our population make it possible that cecal volvulus will be seen with increasing frequency in the future.
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PMID:Cecal bascule: an overlooked diagnosis in the elderly. 172 51

Bacterial peritonitis has been known to complicate severe liver disease. Aerobic organisms are responsible for the vast majority of cases, whereas anaerobic bacteria are responsible for less than 5% of all cases reported in the literature. We now report a case of Clostridium cadaveris anaerobic bacterial peritonitis in a 58-yr-old female, an organism that to our knowledge has not been previously implicated as an infectious agent in this entity.
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PMID:Clostridium cadaveris: an unusual cause of spontaneous bacterial peritonitis. 172 12

Forty-one episodes of ascitic fluid infection were treated with cefotaxime 2 g intravenously every 8 hr, and ascitic fluid and serum were sampled 6, 12, 24, 48, and 96 hr after the first dose of antibiotic. Concentrations of cefotaxime and desacetyl cefotaxime were measured in ascitic fluid and serum by high-performance liquid chromatography. There was essentially 100% penetration of cefotaxime and metabolite from serum into ascitic fluid at all time points. Ascitic fluid was sterilized in 94% of episodes after the first dose of antibiotic. The ascitic fluid concentration of cefotaxime 6 hr after the first dose of antibiotic was greater than 20 times the minimal inhibitory concentration of the drug for 90% of the isolated flora. This rapid ascitic fluid penetration of cefotaxime in high concentration explains the rapid sterilization of ascitic fluid by the drug in the setting of bacterial peritonitis and obviates the need to give a loading dose or intraperitoneal injection.
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PMID:Ascitic fluid and serum cefotaxime and desacetyl cefotaxime levels in patients treated for bacterial peritonitis. 174 49

Endogenous bacterial endophthalmitis occurred in a hepatitis B virus carrier during an episode of severe hepatitis complicated by anaerobic septicemia and possible spontaneous bacterial peritonitis. This may well represent another complication of severe hepatitis with anaerobic bacteremia.
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PMID:Endogenous septic endophthalmitis in severe acute hepatitis with septicemia. 176 44

The pharmacokinetics of ceftazidime were studied in 18 male individuals, including six healthy volunteers and 12 patients with liver cirrhosis and ascites. Each participant received 1 g of ceftazidime as a single intravenous bolus injection. The elimination half-life was longer in cirrhotic than in control patients (5.40 +/- 1.02 h) vs. (1.98 +/- 0.24 h), P less than 0.01; probably due to slow return from the ascitic compartment. Nevertheless, total body clearance did not differ significantly between the two groups (81.4 +/- 30.3 ml/h/kg vs. 83.6 +/- 24.9 ml/h/kg). Dose reduction is not necessary when treating systemic infection in cirrhotics. Ceftazidime attained a concentration of 1 microgram/ml in the ascitic fluid in most patients 15 to 30 min after the injection, and maintained this level, which is higher than the MIC90 of Enterobacteriaceae, for 24 h. An intravenous bolus injection of 1 g ceftazidime every 24 h is sufficient to treat patients with spontaneous bacterial peritonitis caused by a susceptible organism other than Pseudomonas aeruginosa.
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PMID:Pharmacokinetics of ceftazidime in patients with liver cirrhosis and ascites. 176 47

Infections are frequent in patients with liver cirrhosis, as their defenses against infectious agents are altered. But bacteremia occurring in cirrhotic patients has seldom been reported in the literature. From 1981 to 1986, we collected 197 cases with 228 episodes of bacteremia for this retrospective study. The incidence of bacteremia in cirrhotic patients was 8.8%; no significant difference was noted between cirrhotic patients with variant etiologies of HBV(+), HBV(-) and alcohol. But the incidence increased with the severity of the disease (1%, 4.8%, 17.1% in Child's A, B, C groups, respectively). Gram-negative bacteria were the predominant microorganisms of bacteremia (75.6%). Among them, Escherichia coli, Klebsiella pneumoniae and Aeromonas hydrophilia were the three most commonly detected microorganisms. Gram-positive bacterias were detected in 21.2% of patients with bacteremia, with predominance of the Streptococcus group and Staphylococcus aureus. In about 26.3% of cases the infectious sources were the same by bacteria cultures as from blood. The most common sources were spontaneous bacterial peritonitis, urinary tract infection, pneumonia and biliary tree infection. In cirrhotic patients with and without bacteremia, the mortality rate increased significantly in the bacteremia group (54.8% vs 23.2%, P less than 0.05). By Child's classification, the mortality of patients with classes B and C increased significantly after onset of bacteremia. There was no significant difference in mortality between bacteremic patients in the HBV(+), HBV(-) and alcohol groups. In conclusion, bacteremia is a severe complication of liver cirrhosis and a sign of a poor prognosis.
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PMID:Bacteremia in patients with cirrhosis of the liver. 177 12

Acid phosphatase (AcP), beta-glucuronidase (GR) and N-acetyl-beta-D-glucosaminidase (NAG) activity was determined, using semiquantitative cytochemical methods, in the peritoneal fluid lymphocytes obtained from 50 patients with terminal renal failure treated by intermittent peritoneal dialysis. The control group included 30 subjects with normal renal function. The percentage of AcP and NAG-positive lymphocytes was significantly lower and that of the GR-positive cells significantly higher in dialysed patients than in the control group. A group of 22 dialysed patients with bacterial peritonitis showed a significant increase of the percentage of NAG-positive lymphocytes as compared with both the subjects in the control group and the peritonitis-free dialysed ones. Changes of the lymphocytes enzymatic activities were distinct in cells exhibiting the granular reaction type, and to a much lesser extent in those showing granular diffuse reaction.
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PMID:Activity of some lysosomal enzymes in peritoneal lymphocytes from patients with terminal renal failure treated by intermittent peritoneal dialysis. 178 45

Cefotaxime has in the past decade proved to be a most useful agent. It has established the efficacy and safety suggested in the early in vitro, pharmacological and clinical papers. It remains an excellent agent to treat many community and hospital-acquired respiratory infections, urinary tract infections, meningitis, particularly in pediatrics, spontaneous bacterial peritonitis and selected abdominal and gynecological infections.
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PMID:Cephalosporins--cefotaxime 10 years later, a major drug with continued use. 179 Oct 75


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