Articles: sepsis.
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Obstetrics and gynecology · Aug 1984
Case Reports Comparative StudyBacteremia in obstetrics and gynecology.
Surveillance of all episodes of bacteremia in the four major hospitals of a metropolitan area of 400,000 population between 1977 and 1981 revealed that bacteremia was documented in only 92 patients on obstetrics and gynecology services. Death was attributed to bacteremia in only four of these patients, three of whom had severe underlying diseases. These data confirm that death due to bacteremia in present-day obstetric and gynecology practice is extremely uncommon.
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It is suspected, but still unproven, that the increased capillary permeability which accompanies sepsis and contributes to the development of pulmonary edema (PE) involves systemic as well as pulmonary capillaries. We investigated the relationship between the colloid osmotic pressure of serum (COPS) and edema fluid (COPE) in 16 septic and 19 nonseptic patients with severe generalized edema. COPS values of septic and nonseptic patients were not significantly different (14.6 +/- 2.1 and 15.8 +/- 3.4 torr, respectively). ⋯ Thus, 16/17 determinations in septic patients had a ratio greater than .1, while 17/22 determinations in nonseptic patients showed a ratio less than .1. PE was present in 8/16 septic patients but in only 2/19 nonseptic patients. These data suggest that the increase in capillary permeability during sepsis is generalized.
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Despite the multiple organ involvement seen in meningococcal disease, there is little in the literature to support gastrointestinal symptoms as the predominant finding. In the past year four patients with meningococcemia and meningitis presented with gastrointestinal symptoms. In three cases the gastrointestinal findings were of such severity that the diagnosis of meningococcemia was obscured.