11/66. pelvic inflammatory disease and sepsis.pelvic inflammatory disease affects approximately 1 million women per year in the united states alone and has a variety of causative organisms. Because the diagnosis of PID is based on clinical judgment, health care providers need to be guided by the CDC recommendations for diagnosing and treating PID. Because presenting symptoms are often vague, the health care provider should assess female patients for risky behaviors that may lead to PID and should use screening data when making clinical judgments and differential diagnoses. Whenever possible, female patients with PID should be treated as outpatients. If diagnosis and treatment are not performed in a timely manner, PID may cause sepsis, septic shock, and even death. Even if they survive, as many as 15% to 20% of these women experience long-term sequelae of PID, such as ectopic pregnancy, tubo-ovarian abscess, infertility, dyspareunia, and chronic pelvic pain. The best treatments for PID are interventions that lead to prevention and early detection. The critical care nurse has an important role in recognizing the variables that may lead to PID-related sepsis and in encouraging health-seeking and health-maintenance behaviors among women with these diagnoses.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
12/66. A premature infant with fulminant meningococcal septicaemia.The case is described of a 10-week-old preterm infant, a twin boy born at 34 weeks of gestational age. The day after a hernia operation he had a rapidly progressive fulminant neisseria meningitidis serogroup B septicaemia, of which he died despite immediate and adequate treatment. No secondary cases occurred among other infants on the neonatal intensive care unit. Epidemiological investigation revealed that of 185 bacterial throat cultures performed on 17 infants on the ward, 37 close relatives to the infants and 131 medical personnel in contact with the deceased patient, 4 (2.2%) were asymptomatic carriers of N. meningitidis. serotyping and pulsed-field gel electrophoresis of the genomic dna of the N. meningitidis isolates revealed that the infant and his father had closely related strains.- - - - - - - - - - ranking = 1.3506705906505keywords = gestation (Clic here for more details about this article) |
13/66. Use of a temporary vena cava filter in a woman with septic abortion and inferior vena cava thrombosis. A case report.BACKGROUND: Ovarian vein and inferior vena cava (IVC) thrombosis are rare but life-threatening complications of severe obstetric infections. IVC filters have been used to reduce the risk of pulmonary embolus in patients who have recurrent thrombotic and embolic events or underlying risk factors. More recently, retrievable IVC filters have been used in patients in whom the risk is transient. CASE: At 18 weeks' gestation a multigravida with a fetus with anencephaly became septic after laminaria placement and rupture of the membranes. She developed ovarian vein and IVC thrombosis and was treated successfully with a retrievable IVC filter, anticoagulation and antibiotics. The filter was removed after 9 days. CONCLUSION: In young patients at transient risk for emboli and requiring placement of an IVC filter, a retrievable filter should be considered to reduce the long-term risks of an indwelling filter.- - - - - - - - - - ranking = 1.3506705906505keywords = gestation (Clic here for more details about this article) |
14/66. Extensive hepatic necrosis in a premature infant.A fatal case of fulminant hepatic failure that occurred in the neonatal period is reported in a premature infant born after 27 4/7-weeks' gestation. Immediately after birth the infant had severe hypoxia and hypotension resulting from birth asphyxia, hypovolemic shock, and septicemia. At autopsy, histological appearance of the liver showed virtually total hepatocellular necrosis without features of fibrosis. Although the exact cause of hepatocellular injury cannot be fully ascertained, it is assumed that hypoxia and hypotension must have been the predominant factors leading to massive hepatic necrosis.- - - - - - - - - - ranking = 1.3506705906505keywords = gestation (Clic here for more details about this article) |
15/66. Acute leukemia in pregnancy with ovarian metastasis: a case report and review of the literature.Acute leukemias tend to affect a younger population and are much more common in pregnant patients than chronic leukemias are. We report a case of acute lymphoblastic leukemia diagnosed during the third trimester presenting with organomegaly and thrombocytopenia. Delivery of the fetus by cesarean section was decided because of the fulminant nature of the acute leukemia within days of admission. bone marrow biopsy revealed acute lymphocytic leukemia, French American-British L2 subtype B cell immunotype. A left ovarian mass was identified during the cesarean section which later proved to be lymphoblastic infiltration. The patient was started on induction chemotherapy consisting of vincristine, daunorubicin, prednisolone, and l-asparaginase immediately after the diagnosis. The patient died of acinetobacter septicemia 18 days after the first admission.- - - - - - - - - - ranking = 4keywords = pregnancy (Clic here for more details about this article) |
16/66. Renal tumor causing haematuria and sepsis.A 28 year old female patient developed hematuria in the 32th week of her pregnancy. She was given antibiotic treatment, since a urinary tract infection was suspected. After delivery symptoms of acute pyelonephritis, then sepsis developed, and conservative therapy had no effect. Ultrasound examination showed unusual renal destruction, so nephrectomy was performed. Surgical intervention revealed the presence of an advanced tumor of the kidney, while histological examination confirmed a Bellini duct carcinoma of the kidney.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
17/66. brain abscesses after serratia marcescens infection on a neonatal intensive care unit: differences on serial imaging.Serratia are known to be a possible cause of severe cerebral infections in neonates. We describe imaging of three premature infants infected with serratia marcescens. Born in the 31( st), 25( th) and 28( th) weeks of gestation, they presented with signs of septicaemia on postnatal days 9, 24 and 32. Initial sonography showed cysts in the first child, two areas with anechoic centre and echogenic rim in the second, and several echogenic areas in the third. Lesions were seen on CT, of low density in two cases and minimally increased density in the third. MRI in the first patient showed cysts with incomplete contrast enhancement of the lesions, while patient 2 showed five ring-enhancing fluid-containing lesions with thick walls. In the third patient two abscesses with contrast enhancement and several high-signal spots were seen. We discuss the pathophysiology of the lesions and the impact of the various imaging methods.- - - - - - - - - - ranking = 1.3506705906505keywords = gestation (Clic here for more details about this article) |
18/66. actinomyces species and cerclage placement in neonatal sepsis: a case report.A 26-year-old female with a history of preterm labor and cerclage placement presented at 29 weeks gestation. Twin girls were delivered at 2917 weeks. Twin A presented with clinical sepsis at birth. Twin A's blood cultures became positive for actinomyces species on day of life 15. Despite aggressive medical management twin A died at 35 days of life.- - - - - - - - - - ranking = 1.3506705906505keywords = gestation (Clic here for more details about this article) |
19/66. sepsis and multisystem organ failure in a woman attempting interval delivery in a triplet pregnancy: a case report.BACKGROUND: Interval delivery of the fetuses in multiple gestations has been shown to increase perinatal survival. CASE: A woman attempting interval delivery of triplets at 21 weeks developed chorioamnionitis, acute respiratory distress syndrome and tubular necrosis 7 days after delivery of the first fetus. CONCLUSION: When counseling women about the typically favorable outcomes of delayed interval deliveries, physicians should also warn of the potential risk of complications.- - - - - - - - - - ranking = 5.3506705906505keywords = gestation, pregnancy (Clic here for more details about this article) |
20/66. Neonatal venous cerebral hemorrhage. Report of two cases.Intracranial pathological changes can occur as a result of impaired craniocervical venous return. thrombosis of central venous access catheters was demonstrated in two neonates born at 38 and 27 weeks' gestation. Neither infant developed hemorrhage of prematurity as confirmed on cranial ultrasonography. Clinical evidence of vena cava thrombosis and associated spontaneous intraventricular hemorrhage developed on Day 24 and 36, respectively, and these findings were confirmed on imaging studies. In one infant the hemorrhage was accompanied by communicating hydrocephalus. The cause of the intracranial disease was attributable to the retrograde cerebral venous congestion. This, together with the primitive venous bed developing in the periventricular region, was associated with the spontaneous hemorrhage in the region of the foramen of Monro. To the authors' knowledge, this is the first report in the English-language literature of spontaneous neonatal intracerebral hemorrhage, due to thrombosis of the superior or inferior vena cava. The natural history of this condition is resolution without sequelae after appropriate therapeutic intervention for the vena cava thrombosis.- - - - - - - - - - ranking = 1.3506705906505keywords = gestation (Clic here for more details about this article) |
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