Articles: sepsis.
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Coagulation studies were performed on 16 children with gram-negative septicemia without the complications of septic shock, liver disease, malnutrition, or laboratory evidence of classic disseminated intravascular coagulation (DIC). Ten (63%) of the 16 cases were found to have abnormal partial thromboplastin and/or prothrombin times. ⋯ The mechanism that produced this coagulopathy was not known, but evidence was found that suggested that endotoxin may interfere with the vitamin K-carboxylation reaction. The data indicated that abnormal coagulation screening test results in children with gram-negative septicemia were not specific for DIC and that a significant number of patients had a coagulopathy not related to DIC.
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Br Med J (Clin Res Ed) · Feb 1984
Case ReportsMeningococcal septicaemia treated with combined plasmapheresis and leucapheresis or with blood exchange.
Mortality among patients suffering from meningococcal septicaemia has reached nearly 50% in parts of northern Norway despite intensive care. The activation of complement and blood cells by endotoxin is assumed to be the cause of most of the associated pathophysiological changes. ⋯ All recovered without sequelae, and no complications or serious problems caused by these procedures were observed. It is concluded that either combined leucapheresis and plasmapheresis or blood exchange is well tolerated and a valuable supplement to conventional intensive care in fulminant meningococcal septicaemia.
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Oral Surg. Oral Med. Oral Pathol. · Jan 1984
The asplenic patient: a consideration for antimicrobial prophylaxis.
Removal of the spleen predisposes the patient to the development of overwhelming sepsis without a primary site of infection. Transient, usually asymptomatic, bacteremias occur in a wide variety of dental manipulations, particularly those involving the mucous membranes. Occasionally these bacteremias can give rise to serious complications in susceptible patients. A prophylactic preoperative and postoperative antimicrobial regimen is presented for asplenic patients undergoing bacteremia-causing dental treatment.