Articles: sepsis.
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The clinical, epidemiological and laboratory characteristics of bacteremia caused by anaerobic organisms other than Clostridium spp. in cancer patients are described and compared to other previously reported series. Of the 315 episodes, 246 (78%) were caused by a single organism and 69 (22%) were polymicrobial. The most common underlying malignancies were genitourinary and gynecological tumors, acute leukemia, and gastrointestinal malignancies. ⋯ Overall response to penicillin was only 13%. Suboptimal responses were also observed for the antipseudomonal penicillins. High response rates (82%) were also obtained with cefoxitin, metronidazole, and moxalactam.
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Critical care medicine · May 1989
Sepsis syndrome: a valid clinical entity. Methylprednisolone Severe Sepsis Study Group.
The sepsis syndrome represents a systemic response to infection and is defined as hypothermia (temperature less than 96 degrees F) or hyperthermia (greater than 101 degrees F), tachycardia (greater than 90 beat/min), tachypnea (greater than 20 breath/min), clinical evidence of an infection site and with at least one end-organ demonstrating inadequate perfusion or dysfunction expressed as poor or altered cerebral function, hypoxemia (PaO2 less than 75 torr), elevated plasma lactate, or oliguria (urine output less than 30 ml/h or 0.5 ml/kg body weight.h without corrective therapy). One hundred ninety-one patients with the sepsis syndrome were evaluated prospectively and comprised the placebo group of a multicenter trial of methylprednisolone in sepsis syndrome and septic shock. Forty-five percent of the patients were found to be bacteremic. ⋯ Mortality for the patients with sepsis syndrome who did not develop shock was 13%. Mortality for the groups of patients with shock on admission and shock postadmission was 27.5% and 43.2%, respectively. Forty-seven percent of the bacteremic patients developed shock after study admission compared to 29.6% of the nonbacteremic patients (p less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)
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Fulminant sepsis following splenectomy remains a major problem. Even with the administration of pneumococcal vaccine and prophylactic antibiotics fatalities still occur. A better understanding of the complex immunological function of the spleen, its preservation as much as possible during surgery, potent vaccine and perhaps more effective antibiotics will, hopefully, help reduce mortality in some of these cases in future.
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J. Clin. Microbiol. · Feb 1989
Capnocytophaga canimorsus sp. nov. (formerly CDC group DF-2), a cause of septicemia following dog bite, and C. cynodegmi sp. nov., a cause of localized wound infection following dog bite.
CDC group DF-2 is the vernacular name given to a slow-growing gram-negative bacterium that causes septicemia and meningitis in humans. Infections frequently (one-third of cases) occur following dog bites or close contact with dogs or occasionally with cats. Splenectomy and alcoholism appear to be strong predisposing factors for DF-2 infection. ⋯ Both groups are phenotypically and genetically distinct from Capnocytophaga species, although they do share several characteristics with Capnocytophaga species, including cellular morphology, gliding motility, cellular fatty acid composition, enhancement of growth in a candle jar atmosphere, and G+C content. The new species differ from Capnocytophaga species by their positive oxidase and catalase reactions. We chose to avoid creating a new genus and proposed the names Capnocytophaga canimorsus sp. nov. for group DF-2 and C. cynodegmi sp. nov. for the DF-2-like strains.