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rapidly developing septic shock

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https://www.readbyqxmd.com/read/29122896/persistent-bacteraemia-caused-by-staphylococcus-aureus-in-the-gall-bladder
#1
Alexander Tin Han Yu, Tony Cun, Esther Benamu, Cybele Renault
Staphylococcus aureusbacteraemia (SAB) remains a complex disease with a high associated morbidity and mortality, especially when it is able to establish an occult nidus safe from antimicrobial eradication. Without rapid identification and intervention, the nidus can cause persistent relapse of disease, morbidity and mortality. Having a high clinical suspicion for the foci of occult S. aureus is important, and awareness of potential sites of infection is critical and can be life-saving.We present a unique case of a 65-year-old man with end-stage renal disease receiving haemodialysis who developed septic shock from SAB...
November 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29109870/acute-onset-panhypopituitarism-nearly-missed-by-initial-cosyntropin-testing
#2
Claudine A Blum, Daniel Schneeberger, Matthias Lang, Janko Rakic, Marc Philippe Michot, Beat Müller
Introduction: Diagnosis of adrenal crisis and panhypopituitarism in patients with septic shock is difficult but crucial for outcome. Case: A 66-year-old woman with metastasized breast cancer presented to the ED with respiratory insufficiency and septic shock after a 2-day history of the flu. After transfer to the ICU, corticosteroids were started in addition to antibiotics, as the patient was vasopressor-nonresponsive. Diabetes insipidus was diagnosed due to polyuria and treated with 4 mg desmopressin...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29033819/an-unusual-presentation-of-pyoderma-gangrenosum-leading-to-systemic-inflammatory-response-syndrome
#3
Ali Didan, Alan Donnelly, Hock Chua
This is a report of an atypical presentation of pyoderma gangrenosum (PG) in a 26-year-old male who had a negative septic screen. The patient had a life-threatening presentation requiring an intensive care unit (ICU) admission for vasopressor support. It was thought that the likely cause of circulatory collapse was an overwhelming cytokine reaction or systemic inflammatory response syndrome (SIRS) secondary to extensive PG lesions rather than septic shock. The patient presented with multiple large ulcers, the largest being 4 cm in diameter on the central chest...
September 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/29023361/procalcitonin-and-mr-proadrenomedullin-combination-with-sofa-and-qsofa-scores-for-sepsis-diagnosis-and-prognosis-a-diagnostic-algorithm
#4
Silvia Spoto, Eleonora Cella, Marina de Cesaris, Luciana Locorriere, Silvia Mazzaroppi, Edoardo Nobile, Arcangela M Lanotte, Lucia Pedicino, Marta Fogolari, Sebastiano Costantino, Giordano Dicuonzo, Massimo Ciccozzi, Silvia Angeletti
PURPOSE: The third Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) defined sepsis as an organ dysfunction consequent to infection. A SOFA score ≥2 identifies sepsis. In this study, PCT and MR-proADM were evaluated along with SOFA and qSOFA scores in patients with sepsis or septic shock. METHODS: One hundred and nine septic patients and 50 patients with non-infectious disease admitted at the Department of Internal Medicine and General Surgery of the University Hospital Campus Bio-Medico of Rome were enrolled...
October 11, 2017: Shock
https://www.readbyqxmd.com/read/28993363/rare-postoperative-complication-clostridium-perfringens-septic-shock-following-elective-abdominal-surgery
#5
Michael Bath, Mark McKelvie, Khalid Canna
Postoperative infections are one of the most common complications in general surgery, and while rates have reduced with the routine administration of perioperative antibiotics, around 5% of patients undergoing a surgical procedure will develop an infective complication.(1) The Gram-positive, obligate anaerobe, Clostridium perfringens, is a well-known pathogen that forms part of both the environmental and gastrointestinal flora.(2) While more commonly associated with food poisoning, anaerobic cellulitis and traumatic gas gangrene, rare cases of spontaneous non-traumatic gas gangrene of abdominal viscera have also been recorded...
October 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28969197/neglected-necrotizing-fasciitis-a-rare-complication-of-spinal-anaesthesia
#6
Karikal Chakaravarthi, Ashish Gupta, Lileswar Kaman
Necrotizing Fasciitis (NF) is a rare, rapidly progressive severe bacterial soft tissue infection with a high mortality rate. NF classically involves the trunk, groin/perineum, lower limbs, and postoperative wound sites. NF secondary to spinal anaesthesia in a young postpartum female is extremely rare. Here we are describing a young postpartum female who underwent cesarean section for the delivery of child but developed NF of the back starting from the site of spinal needle insertion. She was referred to our center after 21 days of surgery with extensive NF...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28915308/mutilating-purpura-fulminans-in-an-adult-with-meningococcal-sepsis
#7
María Elena Arnáiz-García, Ana María Arnáiz-García, Francisco Gutierrez-Diez, Juan Francisco Nistal, Jose María González-Santos, Ivana Pulitani, Carlos Amado-Diago, Javier Arnáiz
We report a dramatic case of meningococcal sepsis manifesting as purpura fulminans in an elderly diabetic woman. Hemodynamic instability and severe bilateral cutaneous lesions involving her hands and feet developed rapidly. Specific antibiotic therapy and the administration of inotropic and vasopressor drugs were initiated. The severity and extension of the cutaneous lesions (attributed to purpura fulminans) worsened because of the need for vasoconstrictors for the treatment of septic shock. Bilateral transmetatarsal and metacarpal amputations were required to stabilize the patient...
September 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28894449/type-i-interferon-induced-by-streptococcus-suis-serotype-2-is-strain-dependent-and-may-be-beneficial-for-host-survival
#8
Jean-Philippe Auger, Agustina Santinón, David Roy, Karen Mossman, Jianguo Xu, Mariela Segura, Marcelo Gottschalk
Streptococcus suis serotype 2 is an important porcine bacterial pathogen and emerging zoonotic agent mainly responsible for sudden death, septic shock, and meningitis, with exacerbated inflammation being a hallmark of the infection. However, serotype 2 strains are genotypically and phenotypically heterogeneous, being composed of a multitude of sequence types (STs) whose virulence greatly varies: the virulent ST1 (Eurasia), highly virulent ST7 (responsible for the human outbreaks in China), and intermediate virulent ST25 (North America) are the most important worldwide...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28876654/ileosigmoid-knotting-a-zimbabwean-case-series
#9
C Mbanje, S Mungazi, A J V Maunganidze
BACKGROUND: Ileosigmoid knotting is a rare cause of intestinal obstruction with a rapidly progressive course, for which expedient surgical intervention is required to avoid mortality. METHOD: A combined retrospective and prospective analysis was performed on 16 patients operated on at PGH with an operative diagnosis of ileosigmoid knotting between February 2011 and April 2016. Data inclusive of demographics, time to presentation and surgery, preoperative diagnostic accuracy, incidence of septic shock and mortality was collected...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28859468/clinical-and-microbiological-factors-associated-with-early-patient-mortality-from-methicillin-resistant-staphylococcus-aureus-bacteremia
#10
Tark Kim, Yong Pil Chong, Ki-Ho Park, Kyung Mi Bang, Su-Jin Park, Sung-Han Kim, Jin-Yong Jeong, Sang-Oh Lee, Sang-Ho Choi, Jun Hee Woo, Yang Soo Kim
Background/Aims: Methicillin-resistant Staphylococcus aureus bacteremia (MRSAB) is a major bloodstream infection with a high mortality rate. Identification of factors associated with early mortality in MRSAB patients would be useful for predicting prognosis and developing new therapeutic options. Methods: A prospective cohort of MRSAB patients was examined between August 2008 and June 2011. Early and late mortality was defined as death within 2 and 28 days of blood culture, respectively...
July 6, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28858918/implementation-of-the-surviving-sepsis-campaign-guidelines
#11
Vikramjit Mukherjee, Laura Evans
PURPOSE OF REVIEW: Early identification and appropriate management of sepsis improves outcomes. Despite convincing data showing the benefits of early recognition and treatment of sepsis and septic shock, implementation of such evidence-based therapy is suboptimal. This review describes methods that have been shown to improve bedside application of the evidence-based guidelines. RECENT FINDINGS: The Surviving Sepsis Campaign (SSC) has developed guidelines for the management of severe sepsis and septic shock...
October 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28845081/soluble-cd14-as-a-diagnostic-and-prognostic-biomarker-in-hematological-patients-with-febrile-neutropenia
#12
Sini Korpelainen, Carina Intke, Sari Hämäläinen, Esa Jantunen, Auni Juutilainen, Kari Pulkki
OBJECTIVE: Elevated levels of a cell surface glycoprotein, soluble cluster of differentiation 14 (sCD14), have been observed in patients with sepsis. Only scarce data are available on sCD14 in hematological patients with chemotherapy-induced febrile neutropenia. The study aim was to investigate sCD14 as an early biomarker in febrile neutropenia after intensive chemotherapy to detect a rapidly deteriorating clinical course early enough to avoid serious infectious complications. PATIENTS AND METHODS: This prospective study included 87 adult hematological patients at the start of febrile neutropenia after intensive chemotherapy for acute myeloid leukemia or after autologous stem cell transplantation...
2017: Disease Markers
https://www.readbyqxmd.com/read/28796065/a-scoring-system-to-predict-mortality-in-infants-with-esophageal-atresia-a-case-control-study
#13
Xiao-Wen Li, Ya-Jun Jiang, Xue-Qiu Wang, Jia-Lin Yu, Lu-Quan Li
Esophageal atresia (EA) is a rare anomaly that mandates surgical intervention. Patients with EA often have complicated medical courses due to both esophageal anomalies and related comorbidities. Although several prognostic classification systems have been developed to decrease the mortality rate in EA, most systems focus only on the influence of the major anomaly, and external risk factors that could be influenced by the neonatal caregivers to a certain extent are not included. The aim of this study was to investigate the risk factors for in-hospital mortality in neonates with EA and develop a scoring model to predict mortality...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28762570/streptococcal-toxic-shock-syndrome-occurring-in-the-third-trimester-of-pregnancy-a-case-report
#14
Mohamad Irani, Rodney McLaren, Richard H Savel, Oksana Bogatyryova, Fady Khoury-Collado
Group A streptococcal (GAS) toxic shock syndrome (TSS) is a rare life-threatening illness. Most reported cases have occurred in the post-partum period. Here, we report a rare case of a primigravid who developed GAS TSS in the third trimester. We also review the potential preventive measures and treatment modalities for this syndrome. A 29-year-old primigravid presented at 36 weeks' gestation with diarrhea, abdominal pain, fever, and fetal bradycardia. She underwent an emergency cesarean section and was subsequently diagnosed with GAS TSS...
August 1, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28667518/screening-cytokine-chemokine-profiles-in-serum-and-organs-from-an-endotoxic-shock-mouse-model-by-liquichip
#15
Jinghua Liu, Juan Wang, Haihua Luo, Zhijie Li, Tianyu Zhong, Jing Tang, Yong Jiang
Studying the cytokine profiles in animal models or patients with sepsis provides an experimental basis for the identification of diagnostic biomarkers and therapeutic targets. In this study, we used a liquid protein chip (LiquiChip), also known as flexible multi-analyte profiling technology, to perform quantitative analyses of several cytokines and chemokines (e.g., IL-1β, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12, TNF-α, IFN-γ, granulocyte-macrophage colony-stimulating factor, keratinocyte chemoattractant, monocyte chemoattractant protein, monokine induced by gamma interferon, IFN-γ-inducible protein 10, and macrophage inflammatory protein 1 alpha)...
May 29, 2017: Science China. Life Sciences
https://www.readbyqxmd.com/read/28591027/necrotizing-fasciitis-a-catastrophic-complication-following-routine-tibia-fracture-surgery-a-case-report-and-literature-review
#16
REVIEW
Shuai Shang, Ruipeng Zhang, Zhiyong Hou
RATIONALE: Necrotizing fasciitis (NF) is defined as a rare, life-threatening, rapidly spreading soft tissue infection resulting from a polymicrobial origin, with a predominance of anaerobic organisms that presents with necrosis of the muscle, fascia, and surrounding soft tissue. PATIENT CONCERNS AND DIAGNOSES: A 64-year-old male who sustained tibia fracture caused by falling from a height underwent a tibia surgery with minimally invasive plate osteosynthesis technique in another institution...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28552276/adjuncts-to-blood-component-therapies-for-the-treatment-of-bleeding-in-the-intensive-care-unit
#17
REVIEW
Jerrold H Levy, Kamrouz Ghadimi, Quintin J Quinones, Raquel R Bartz, Ian Welsby
Patients who are critically ill following surgical or traumatic injury often present with coagulopathy as a component of the complex multisystem dysfunction that clinicians must rapidly diagnose and treat in the intensive care environment. Failure to recognize coagulopathy while volume resuscitation with crystalloid or colloid takes place, or an unbalanced transfusion strategy focused on packed red blood cell transfusion can all significantly worsen coagulopathy, leading to increased transfusion requirements and poor outcomes...
April 25, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28509730/american-college-of-critical-care-medicine-clinical-practice-parameters-for-hemodynamic-support-of-pediatric-and-neonatal-septic-shock
#18
Alan L Davis, Joseph A Carcillo, Rajesh K Aneja, Andreas J Deymann, John C Lin, Trung C Nguyen, Regina S Okhuysen-Cawley, Monica S Relvas, Ranna A Rozenfeld, Peter W Skippen, Bonnie J Stojadinovic, Eric A Williams, Tim S Yeh, Fran Balamuth, Joe Brierley, Allan R de Caen, Ira M Cheifetz, Karen Choong, Edward Conway, Timothy Cornell, Allan Doctor, Marc-Andre Dugas, Jonathan D Feldman, Julie C Fitzgerald, Heidi R Flori, James D Fortenberry, Ana Lia Graciano, Bruce M Greenwald, Mark W Hall, Yong Yun Han, Lynn J Hernan, Jose E Irazuzta, Elizabeth Iselin, Elise W van der Jagt, Howard E Jeffries, Saraswati Kache, Chhavi Katyal, Niranjan Tex Kissoon, Alexander A Kon, Martha C Kutko, Graeme MacLaren, Timothy Maul, Renuka Mehta, Fola Odetola, Kristine Parbuoni, Raina Paul, Mark J Peters, Suchitra Ranjit, Karin E Reuter-Rice, Eduardo J Schnitzler, Halden F Scott, Adalberto Torres, Jacki Weingarten-Abrams, Scott L Weiss, Jerry J Zimmerman, Aaron L Zuckerberg
OBJECTIVES: The American College of Critical Care Medicine provided 2002 and 2007 guidelines for hemodynamic support of newborn and pediatric septic shock. Provide the 2014 update of the 2007 American College of Critical Care Medicine "Clinical Guidelines for Hemodynamic Support of Neonates and Children with Septic Shock." DESIGN: Society of Critical Care Medicine members were identified from general solicitation at Society of Critical Care Medicine Educational and Scientific Symposia (2006-2014)...
June 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28507971/lethal-necrotizing-fasciitis-triggered-by-plaster-case-report-and-review-of-literature
#19
Mohit J Jain, Kinjal Mavani
INTRODUCTION: Plasters have been frequently associated with known complications such as infection, and compartment syndrome or deep vein thrombosis. However, life-threatening complication of necrotizing fasciitis (NF) has not been frequently attributed to plaster. CASE REPORT: We had a case of a 62-year male developing a lethal NF triggered by a below knee plaster for undisplaced fracture medial malleolus after twisting injury. He had no history suggestive of diabetes, renal impairment, and predisposing allergic factors or any comorbidity...
November 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28404756/infusion-compatible-antibiotic-formulations-for-rapid-administration-to-improve-outcomes-in-cancer-outpatients-with-severe-sepsis-and-septic-shock-the-sepsis-stat-pack
#20
Jason D Goldman, Amelia Gallaher, Rupali Jain, Zach Stednick, Manoj Menon, Michael J Boeckh, Paul S Pottinger, Stephen M Schwartz, Corey Casper
Background: Patients with cancer are at high risk for severe sepsis and septic shock (SS/SSh), and a delay in receiving effective antibiotics is strongly associated with mortality. Delays are due to logistics of clinic flow and drug delivery. In an era of increasing antimicrobial resistance, combination therapy may be superior to monotherapy for patients with SS/SSh. Patients and Methods: At the Seattle Cancer Care Alliance, we implemented the Sepsis STAT Pack (SSP) program to simplify timely and effective provision of empiric antibiotics and other resuscitative care to outpatients with cancer with suspected SS/SSh before hospitalization...
April 2017: Journal of the National Comprehensive Cancer Network: JNCCN
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