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sepsis and thrombocytopenia

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https://www.readbyqxmd.com/read/28203580/unusual-presentation-of-diffuse-large-b-cell-lymphoma-with-splenic-infarcts
#1
Vivek Kumar, Parita Soni, Vishangi Dave, Jonathan Harris
A 67-year-old man presented with a 3-day history of abdominal pain, fever, and significant weight loss over 2 months. Physical examination revealed left upper quadrant tenderness, hepatomegaly, splenomegaly, and bilateral pitting edema but peripheral lymphadenopathy was absent. Laboratory tests showed anemia, thrombocytopenia, elevated prothrombin time (PT), partial thromboplastin time (PTT), and increased lactate dehydrogenase (LDH). PTT was corrected completely in mixing study. Further workup for the cause of coagulopathy revealed decreased levels of all clotting factors except factor VIII and increase fibrinogen levels, which ruled out disseminated intravascular coagulation (DIC)...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28178107/late-onset-neonatal-sepsis-a-10-year-review-from-north-queensland-australia
#2
Harsha Gowda, Robert Norton, Andrew White, Yogavijayan Kandasamy
OBJECTIVE: Late-onset sepsis (LOS) in neonates contributes significantly to both morbidity and mortality. To determine the incidence of LOS, risk factors for disease, and the impact on subsequent hospital course, we evaluated a cohort of 6340 neonates admitted to the neonatal intensive care unit and of neonates (3-28 days) admitted from the community between January 2005 and January 2016. METHODS: This was a retrospective case review of all neonates admitted with suspected LOS who had positive blood culture and/or cerebrospinal fluid (CSF) cultures, for an organism determined to be a pathogen...
February 1, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28161323/a-multicenter-phase-i-study-of-cabazitaxel-mitoxantrone-and-prednisone-for-chemotherapy-na%C3%A3-ve-patients-with-metastatic-castration-resistant-prostate-cancer-a-department-of-defense-prostate-cancer-clinical-trials-consortium-study
#3
Rahul Aggarwal, Alan Bryce, Charles J Ryan, Andrea Harzstark, Christina Derleth, Won Kim, Terence Friedlander, Amy M Lin, Tammy Rodvelt-Bagchi, Mallika Dhawan, Li Zhang, Mina Lee, Eric Siebeneck, Jeffrey Hough, Eric J Small
BACKGROUND: Cabazitaxel plus prednisone has significant activity in patients with chemotherapy-naïve and pretreated metastatic castration-resistant prostate cancer (mCRPC). Mitoxantrone has antitumor activity in mCRPC and nonoverlapping mechanism of action and toxicity profile. OBJECTIVE: To establish the maximally tolerated dose of the combination of cabazitaxel, mitoxantrone, and prednisone. METHODS AND MATERIALS: Patients with chemotherapy-naïve mCRPC were prospectively enrolled in a multicenter phase 1 trial...
February 1, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28151843/pseudomonas-aeruginosa-associated-diarrheal-diseases-in-children
#4
Chih-Hsien Chuang, Rajendra Prasad Janapatla, Yi-Hsin Wang, Hsin-Ju Chang, Yhu-Chering Huang, Tzou-Yien Lin, Cheng-Hsun Chiu
BACKGROUND: The gastrointestinal tract is not the common infection site of Pseudomonas aeruginosa. The role of P. aeruginosa as a causative agent for diarrhea in children without pre-existing disease is controversial. METHODS: From 2003 to 2012 we reviewed the records of 259 diarrheal patients less than 5 years of age whose stool culture grew P. aeruginosa. Virulence phenotypes of bacterial isolates were determined in vitro, including cytotoxicity, penetration and adherence to epithelial cells...
January 31, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28149700/retrospective-study-of-prognostic-factors-in-pediatric-invasive-pneumococcal-disease
#5
Nan-Chang Chiu, Hsin Chi, Chun-Chih Peng, Hung-Yang Chang, Daniel Tsung-Ning Huang, Lung Chang, Wei-Te Lei, Chien-Yu Lin
Streptococcus pneumoniae remains the leading causative pathogen in pediatric pneumonia and bacteremia throughout the world. The invasive pneumococcal disease (IPD) is known as isolation of S. pneumoniae from a normally sterile site (e.g., blood, cerebrospinal fluid, synovial fluid, pericardial fluid, pleural fluid, or peritoneal fluid). The aim of this study is to survey the clinical manifestations and laboratory results of IPD and identify the prognostic factors of mortality. From January 2001 to December 2006, a retrospective review of chart was performed in a teaching hospital in Taipei...
2017: PeerJ
https://www.readbyqxmd.com/read/28092405/thrombin-contributes-to-protective-immunity-in-pneumonia-derived-sepsis-via-fibrin-polymerization-and-platelet-neutrophil-interactions
#6
T A M Claushuis, S F de Stoppelaar, I Stroo, J J T H Roelofs, R Ottenhoff, T van der Poll, C Van't Veer
: Essentials Immunity and coagulation are linked during sepsis but the role of thrombin is not fully elucidated. We investigated the effect of thrombin inhibition on murine Klebsiella pneumosepsis outcome. Thrombin is crucial for survival and limiting bacterial growth in pneumonia derived sepsis. Thrombin improves host defense via fibrin and enhancement of platelet-neutrophil interactions. SUMMARY: Background Innate immunity and coagulation are closely linked during sepsis...
January 16, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28063304/splenic-irradiation-for-splenomegaly-a-systematic-review
#7
REVIEW
Nicholas G Zaorsky, Graeme R Williams, Stefan K Barta, Nestor F Esnaola, Patricia L Kropf, Shelly B Hayes, Joshua E Meyer
Splenic irradiation (SI) is a palliative treatment option for symptomatic splenomegaly (i.e. for pain, early satiety, pancytopenia from sequestration) secondary to hematologic malignancies and disorders. The purpose of the current article is to review the literature on SI for hematologic malignancies and disorders, including: (1) patient selection and optimal technique; (2) efficacy of SI; and (3) toxicities of SI. PICOS/PRISMA methods are used to select 27 articles including 766 courses of SI for 486 patients from 1960 to 2016...
February 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28054307/etiology-and-complications-of-thrombocytopenia-in-hospitalized-medical-patients
#8
Eric M Fountain, Gowthami M Arepally
To determine incidence, risk factors, hematologic complications, and prognostic significance of thrombocytopenia in the general medicine population, we performed a single-institutional, retrospective study of all adult patients admitted to a general medical ward from January 1st, 2014 to December 31st, 2014 with hospital-acquired thrombocytopenia. Those with moderate thrombocytopenia, defined as a platelet count nadir of <100 × 10^9/L and/or a >50% relative decline, were compared to those with less severe thrombocytopenia...
January 4, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28040771/transplantation-in-a-patient-on-extracorporeal-membrane-oxygenation-with-infective-endocarditis-pericarditis-and-heparin-induced-thrombocytopenia
#9
Eunise Chen, Nicholas Clarke, Lynn Huffman, Matthias Peltz
Heart failure patients with pacemaker or defibrillator-associated endocarditis in cardiogenic shock have few treatment options. We present a case of an INTERMACS I patient who developed device infection, sepsis, bacterial pericarditis and heparin-induced thrombocytopenia. The patient was stabilized with extracorporeal membrane oxygenation and successfully transplanted.
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28034871/how-i-evaluate-and-treat-thrombocytopenia-in-the-intensive-care-unit-patient
#10
REVIEW
Andreas Greinacher, Sixten Selleng
Multiple causes (pseudothrombocytopenia, hemodilution, increased consumption, decreased production, increased sequestration, and immune-mediated destruction of platelets) alone or in combination make thrombocytopenia very common in intensive care unit (ICU) patients. Persisting thrombocytopenia in critically ill patients is associated with, but not causative of, increased mortality. Identification of the underlying cause is key for management decisions in individual patients. While platelet transfusion might be indicated in patients with impaired platelet production or increased platelet destruction, it could be deleterious in patients with increased intravascular platelet activation...
December 29, 2016: Blood
https://www.readbyqxmd.com/read/28013100/the-impact-of-highly-active-antiretroviral-therapy-on-obstetric-conditions-a-review
#11
REVIEW
Hannah M Sebitloane, Dhayendre Moodley
HIV is the leading cause of maternal and neonatal morbidity and mortality in resource constrained countries. Highly active antiretroviral treatment (HAART) initiated in pregnancy has now almost eliminated mother to child transmission of the virus, and is beginning to show the desired effect of reducing HIV related maternal mortality. By modulating host immunological responses HAART has the potential to alter infections during pregnancy, in addition to modifying clinical conditions such as preeclampsia. There is increasing evidence of the benefits of HAART given to pregnant women, however there is paucity of data that distinguishes HIV or HAART as the cause or exacerbation of pre-existing medical conditions or conditions specific to pregnancy...
December 9, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28007287/cross-reactivity-between-heparin-and-danaparoid-antibodies-in-cardiac-surgery
#12
Thibault Ronchard, Erwan Salaun, Alexis Theron, Dominique Grisoli, Nicolas Jaussaud, Frédéric Collart, Gilbert Habib, Laurence Camoin-Jau
Management of heparin-induced thrombocytopenia (HIT) entails cessation of heparin and initiation of a nonheparin parenteral anticoagulant such as danaparoid. Danaparoid cross-reactivity with HIT antibodies is an uncommon complication of treatment of HIT. We report the case of confirmed HIT and in vivo cross-reactivity with danaparoid, complicating severe sepsis due to an infectious endocarditis treated by cardiac surgery.
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27924246/adenovirus-and-culture-negative-sepsis-in-a-preterm-neonate
#13
Mohannad Moallem, Eunkyung Song, Preeti Jaggi, Miriam R Conces, Adriana E Kajon, Pablo J Sánchez
Background Respiratory viral infections remain an underrecognized cause of morbidity and mortality among preterm infants in the neonatal intensive care unit (NICU). Case Report An eight day old, 650 gram birth weight, 23 weeks' gestational age female developed "culture-negative" sepsis manifested by respiratory deterioration, hypoxia, leukocytosis, and thrombocytopenia. She was diagnosed with pneumonia and hepatitis due to adenovirus HAdV-D (H29F9) by polymerase chain reaction (PCR) testing, but died at the age of 18 days despite treatment with cidofovir and immune globulin intravenous...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/27922757/hemophagocytic-lymphohistiocytosis-triggered-by-gaucher-disease-in-a-preterm-neonate
#14
Simone Schüller, Andishe Attarbaschi, Angelika Berger, Caroline Hutter, Katrin Klebermass-Schrehof, Manuel Steiner
OBJECTIVE: To present the diagnostic workup in an extremely low birth weight infant patient with signs of both sepsis and hemophagocytosis. PARTICIPANTS: A preterm infant presented with clinical and laboratory signs of early-onset sepsis including hepatosplenomegaly, thrombocytopenia, direct hyperbilirubinemia, and elevated liver enzymes. METHODS: Despite extensive septic workup, no underlying infection was detected. Additional hyperferritinemia and other elevated inflammatory parameters raised the suspicion of a primary or secondary hemophagocytic lymphohistiocytosis (HLH)...
October 2016: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/27902585/long-term-complications-of-splenectomy-in-adult-immune-thrombocytopenia
#15
Lan-Huong Thai, Matthieu Mahévas, Françoise Roudot-Thoraval, Nicolas Limal, Laetitia Languille, Guillaume Dumas, Mehdi Khellaf, Philippe Bierling, Marc Michel, Bertrand Godeau
The recent large decrease in splenectomy use for chronic immune thrombocytopenia (ITP) is partly due to still-unsolved questions about long-term safety. We performed the first single-center exposed/unexposed cohort study evaluating the long-term incidence of splenectomy complications in patients with primary ITP. Overall, 83 patients who underwent splenectomy more than 10 years ago (exposed) were matched with 83 nonsplenectomized patients (unexposed) on the date of ITP diagnosis ±5 years, age and gender. After a median follow-up of 192 months (range 0...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27885699/strains-of-group-b-streptococci-from-septic-patients-induce-platelet-activation-via-toll-like-receptor-2
#16
Xiaoyan Liu, Hongyun Liu, Xianming Luo, Ping Zhang, Yanmin Gao, Shuangfeng Xie, Kang Xu, Jianxing Chang, Liping Ma
Group B Streptococcus (GBS) causes life-threatening bacterial sepsis, especially in newborns and pregnant women. Patients suffering from sepsis often display low platelet counts, characterized by thrombocytopenia, because of platelet activation. In the present study, the roles of six GBS strains from septic patients in platelet aggregation, as well as the underlying mechanisms, were investigated. Incubation of platelets with three of the strains induced platelet aggregation, increased the secretion of cellular adhesin molecule CD62P and activation of GPIIb/IIIa...
November 25, 2016: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/27849621/vancomycin-induced-thrombocytopenia-in-a-newborn
#17
Kunal Kalra, Hema Gupta Mittal, Arti Maria
Neonatal thrombocytopenia is common and is frequently seen in neonatal sepsis. Drug-induced thrombocytopenia is likely to be missed unless a high index of suspicion is present. Changing of antibiotics for assumed nonresolution of sepsis may lead to persistent thrombocytopenia in a neonate if drug-induced thrombocytopenia is missed. Vancomycin-induced neonatal thrombocytopenia is rarely described in scientific literature. We describe a newborn who was diagnosed with early onset sepsis and vancomycin-induced thrombocytopenia...
December 1, 2016: Drug Metabolism and Personalized Therapy
https://www.readbyqxmd.com/read/27834985/clinical-outcome-of-critically-ill-patients-with-thrombocytopenia-and-hypophosphatemia-in-the-early-stage-of-sepsis
#18
Evgeni Brotfain, Andrei Schwartz, Avi Boniel, Leonid Koyfman, Matthew Boyko, Ruslan Kutz, Moti Klein
BACKGROUND: Hypophosphatemia and thrombocytopenia may both be independent risk factors for the development of multiple organ failure and correlate well with the severity of sepsis. In the present study we wanted to analyze the potential clinical role and prognostic significance of both early hypophosphatemia and thrombocytopenia on clinical outcomes of critically ill ICU patients with severe sepsis. METHODS: We analyzed the clinical data, including the outcome of critically ill ICU patients with severe sepsis who presented during a 5 year period with early hypophosphatemia and thrombocytopenia...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27822747/venovenous-extracorporeal-membrane-oxygenation-for-ards-outcome-analysis-of-a-croatian-referral-center-for-respiratory-ecmo
#19
Marko Kutleša, Anđa Novokmet, Renata Josipović Mraović, Bruno Baršić
BACKGROUND: The use of venovenous extracorporeal membrane oxygenation (VV-ECMO) as a rescue therapy in severe acute respiratory distress syndrome (ARDS) has become well established; however, the affirmation of evidence on VV-ECMO application and the analysis of patient outcomes after VV-ECMO treatment for ARDS continues. The aim of the study is to identify variables that affected the outcome of patients treated with VV-ECMO for severe ARDS outside a major ECMO center. METHODS: The study included adult patients with severe ARDS treated with ECMO at a tertiary care hospital in Zagreb, Croatia between October 2009 and July 2014...
November 7, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27807846/borderline-operability-in-hepatectomy-patients-is-associated-with-higher-rates-of-failure-to-rescue-after-severe-complications
#20
Bradford J Kim, Ching-Wei D Tzeng, Amanda B Cooper, Jean-Nicolas Vauthey, Thomas A Aloia
BACKGROUND/OBJECTIVE: To understand the influence of age and comorbidities, this study analyzed the incidence and risk factors for post-hepatectomy morbidity/mortality in patients with "borderline" (BL) operability, defined by the preoperative factors: age ≥75 years, dependent function, lung disease, ascites/varices, myocardial infarction, stroke, steroids, weight loss >10%, and/or sepsis. METHODS: All elective hepatectomies were identified in the 2005-2013 ACS-NSQIP database...
November 3, 2016: Journal of Surgical Oncology
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