Articles: sepsis.
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Pulmonary hypertension gives an indication of poor prognosis in adult respiratory distress syndrome (ARDS) complicating sepsis. In this study, we examined the role of the platelet and the vasoactive amine, serontonin, in pulmonary hypertension accompanying septic ARDS. The lack of any significant difference in platelet number (delta + 3.9 +/- 8.4, X 10(3)/mm3) or serum serotonin (delta - 0.03 +/- 0.06 nm/mm3) across the pulmonary vascular bed (pulmonary artery minus pulmonary vein), would suggest that platelet sequestration and/or release of serotonin is not a major factor in septic ARDS. However, we did note a direct positive relationship between serum serotonin (Ss) and the pulmonary artery diastolic minus pulmonary capillary wedge pressure (PAd-PCWP) gradient (r = 0.64, p < 0.01) implying that serum serotonin may be related to pulmonary hypertension in septic ARDS.
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Postoperative outcomes of 31 afebrile patients who had responded to treatment for intra-abdominal sepsis were compared based on the presence or absence of leukocytosis (WBC count greater than 10,000/cu mm) at the conclusion of antibiotic therapy. In 68% of the patients who had leukocytosis, postoperative septic complications developed within two months of their operation. In patients without leukocytosis, complications developed in only 8.3%. Afebrile patients who exhibit leukocytosis but have responded clinically to treatment are at risk for postoperative infection and multisystem failure.
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Clinical pediatrics · Jul 1980
Case ReportsOccult pneumococcal bacteremia and the febrile infant and young child.
Occult pneumonoccemia (OP) is unsuspected Streptococcus pneumoniae bacteremia occurring in a previously well child who presents with fever associated with either no focus or an upper respiratory focus infection. In this report, four cases of OP are presented and the literature is reviewed. ⋯ Other symptoms associated with OP include irritability, rhinorrhea, and febrile seizures. When recalled because of positive blood cultures, 40 per cent of untreated patients with OP had had spontaneous resolution of their illness, 29 per cent had persistent fever or symptoms and sterile blood cultures, 22 per cent had persistent fever or symptoms and positive blood cultures, while 10 per cent had a febrile course complicated by pneumococcal meningitis.
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The Journal of infection · Jun 1980
Randomized Controlled Trial Comparative Study Clinical TrialTreatment of acute meningococcaemia with chemotherapy and immune plasma.