Articles: sepsis.
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Incidence and fatality of neonatal sepsis in intensive care units have been relatively high despite progress in the management of very ill neonates and combined treatment of sepsis with antibiotics. Between 1985 and 1989 944 children (632 premature babies and 312 term babies) were treated in the intensive care unit of the University Children's Hospital of Kiel. The incidence of sepsis was 5% (congenital sepsis 4%, sepsis acquired after birth 1%). ⋯ Early diagnosis and treatment with piperacillin plus cefotaxime reduced the mortality rate of sepsis to 2%. Sepsis never developed under treatment with piperacillin plus cefotaxime. Early recognition of neonatal sepsis by a good blood culture technique and beginning of treatment on first suspicion of sepsis with cefotaxime and piperacillin can improve the results especially in intensive care patients.
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Sepsis is a frequent complication of central venous catheters, but the diagnosis of catheter sepsis is not always clear-cut. A variety of culture methods is available to determine catheter-related septicemia. Each method has advantages and disadvantages for the clinician to consider. This article reviews qualitative, quantitative, and other culture methods applicable to both blood and the device.
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Toxic shock syndrome, caused by an exotoxin of staphylococcus aureus is very rare in children. On admission, beside the shock, abdominal problems as vomiting, diarrhoea and a developing adynamic ileus were outstanding in our patient. Not before additional symptoms as staphylococcal pneumonia with bacteriemia occurred and later desquamation of palms and feet, diagnosis of toxic shock syndrome could be confirmed.
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Case Reports
Purpura fulminans secondary to Xanthomonas maltophilia sepsis in an adult with aplastic anemia.
Purpura fulminans is a rare disease characterized by purpura ecchymosis, hypotension, and fever associated with disseminated intravascular coagulation. It often begins as a benign infectious process and subsequently progresses to a severe, catastrophic outcome. ⋯ We present an unusual case of an adult with Xanthomonas maltophilia sepsis that subsequently developed into purpura fulminans with involvement of the four extremities. We discuss the importance of the protein C system in coagulation homeostasis and its relationship to purpura fulminans.
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Yonsei medical journal · Mar 1991
Case ReportsLactobacillus casei subspecies casei endocarditis--a case report.
Lactobacillus sp., generally considered to be a harmless indigenous bacteria of the mucous membrane, occasionally causes serious infections. Lactobacillus endocarditis is a very rare disease, and no case has been reported in Korea. Gram-positive bacilli were isolated from blood cultures of a 41-year-old man with clinically suspected subacute bacterial endocarditis. ⋯ The isolate was identified as L. casei subsp. casei based on the cultural characteristics and gas liquid chromatography of metabolic products. The patient was treated with ampicillin and improved. When Lactobacillus is isolated from the blood of an endocarditis patient, the significance should be seriously considered.