Articles: sepsis.
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Two patients with multiple organ failure, septicaemia and a deteriorating clinical course were treated by plasma exchange in addition to standard supportive measures. Dramatic improvements were seen in cardio-respiratory (patient 1), neurological and renal parameters (patient 2) which were attributable to the exchanges. Plasma exchange might be of value as adjunctive therapy where overwhelming septicaemia occurs with multiple organ failure.
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The management of severe bacterial sepsis is an integral part of intensive care medicine. Early and appropriate treatment with antimicrobials positively affects mortality and significantly reduces the time spent in both intensive care and the hospital. Drug choice is usually made on a "best guess" basis and instituted prior to receipt of appropriate blood, sputum, urine or drainage culture results. ⋯ Several newer agents have been more recently introduced. These drugs include ceftazidime, imipenem/cilastatin, the quinolones and clavulanic acid/semisynthetic penicillin combinations. Other newer drugs currently under evaluation include aztreonam, teicoplanin, the penems and carbapenems.
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J Burn Care Rehabil · Jan 1990
Review Case ReportsBranhamella catarrhalis pneumonia with bacteremia in a pediatric patient with smoke inhalation.
Branhamella catarrhalis, a common inhabitant of the upper respiratory tract, has been identified recently as a cause of lower airway infection. In this report we present a case of B. catarrhalis pneumonia and bacteremia in a child with smoke inhalation as the first description of invasive disease involving this organism in a traumatized airway. In addition, other pediatric cases of B. catarrhalis bacteremia are reviewed, suggesting immunocompromise as a risk factor.
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In the following paper a review is given on the development of scoring-systems of severe intraabdominal infections till now. After a critical reflection on various systems a heuristic assessment is shown in the summing-up about their possible utility in the future. At present the APACHE II index, the sepsis score by Elebute and Stoner and the Mannheim peritonitis index meet practically requirements for good scores by different revising questions.
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We report the case of a patient with pemphigus who presented Nocardia asteroides septicemia. The infection was controlled with an original association of trimethoprim-sulfamethoxazole and amikacin.