1/11. Successful treatment of invasive burn wound infection with sepsis in patients with major burns.OBJECTIVE: To investigate the clinical characteristics of invasive burn wound infection with sepsis in patients with major burns and to summarize the successful experiences in the treatment of such patients. methods: Eight patients with major burns, complicated by invasive burn would infection and sepsis were consecutively admitted to our hospital from September 1997 to October 1998. Among them, 6 patients developed multiple organ dysfunction syndrome (MODS) and 2 developed septic shock. The plasma concentrations of IL-6, IL-8, TNF alpha and lypopolysaccharide (LPS) were assayed before and after surgical intervention, as well as when the patient's vital signs became stable. RESULTS: The patients' conditions usually deteriorated abruptly when extensive invasive burn wound infection emerged. While multi-microbial infection was usually found, pseudomonas aeruginosa was the predominant bacteria isolated from the subeschar tissue. The plasma concentrations of IL-6, IL-8, TNF alpha and LPS before surgical intervention were significantly higher than those after surgical intervention (P < 0.05). The lowest levels of the inflammatory mediators were observed when the patients' conditions became stable, and the values were significantly lower than those before surgical intervention (P < 0.001). CONCLUSION: Since the main cause of burn wound sepsis is the presence of a large area of infected burn wound, they should be excised and covered as early as possible. LPS and pro-inflammatory mediators play an important role in the pathogenesis of burn sepsis. Although favorable results should be attributed to comprehensive treatment, we believe that early, aggressive and thorough surgical excision of infected burn wounds, followed by sound and complete coverage of the area, play a crucial role.- - - - - - - - - - ranking = 1keywords = shock, septic shock (Clic here for more details about this article) |
2/11. Septic shock syndrome in the surgical wound care patient.The occurrence of septic shock in lower extremity surgery is rare. Its early identification and treatment are vital to its outcome. The authors present a case history of septic shock occurring in the surgical wound care patient, discuss the pathophysiology of septic shock, and then consider diagnosis along with treatment options.- - - - - - - - - - ranking = 31.607828449725keywords = shock syndrome, shock, septic shock (Clic here for more details about this article) |
3/11. Secretory diarrhea following a dog bite.Overwhelming sepsis is rarely complicated by secretory diarrhea. We present a case of fulminant sepsis associated with dermatologic manifestations, disseminated intravascular coagulation (DIC), and a severe secretory diarrhea that has not previously been described. This followed a dog bite, and the patient was otherwise healthy. The combination of septic shock, skin lesions, and DIC occurring after a dog bite has been attributed to dysgonic fermentor 2 organisms, now called capnocytophaga canimorsus, but none were cultured in this case (7). Dysgonic fermentor-2 may be a new cause of secretory diarrhea and should be considered in the differential diagnosis of overwhelming sepsis associated with diarrhea.- - - - - - - - - - ranking = 1keywords = shock, septic shock (Clic here for more details about this article) |
4/11. Infection with staphylococcus aureus producing toxic shock syndrome (TSS) toxin-1 without TSS.Relevant findings are reported in an 8-year-old boy with skin infection due to staphylococcus aureus producing toxic shock syndrome toxin-1 without shock but with an increase in antibody titre against the toxin.- - - - - - - - - - ranking = 113.79860353452keywords = toxic shock syndrome, shock syndrome, toxic shock, shock (Clic here for more details about this article) |
5/11. Toxic shock syndrome associated with poison oak dermatitis.Toxic shock syndrome commonly occurs in menstruating women, but it is known to be associated with a variety of staphylococcal infections. We report a case of nonmenstrual toxic shock syndrome in an 11-year-old male who presented with altered consciousness and infected poison oak dermatitis of the feet. This is the first reported case of toxic shock syndrome associated with poison oak dermatitis. The signs and symptoms, laboratory findings, and treatment of toxic shock syndrome are reviewed.- - - - - - - - - - ranking = 103.65950468674keywords = toxic shock syndrome, shock syndrome, toxic shock, shock (Clic here for more details about this article) |
6/11. Post-traumatic toxic shock syndrome.Toxic shock syndrome (TSS) associated with Staphylococcus occurs most commonly in menstruating women, although cases in both sexes have been reported. This report describes a severe case of TSS after a relatively minor stab wound. The male patient exhibited all of the major characteristics of this multisystem disease including anuric renal failure. TSS, which can be fatal, may result from surgical and traumatic wound infections and demands prompt recognition and treatment.- - - - - - - - - - ranking = 97.684915945204keywords = toxic shock syndrome, shock syndrome, toxic shock, shock (Clic here for more details about this article) |
7/11. The treatment of burned children.Burn shock in infants and children is satisfactorily treated by the initial intravenous administration of balanced hypertonic sodium solutions; monitoring of plasma sodium and/or osmolarity permits necessary adjustment of the sodium concentration of administered fluids. This approach has been safe. Its principal advantage is in minimizing acute gains in body weight, which may be alarming otherwise, especially in children. Clinical and bacteriological data are presented indicating that cerium nitrate-silver sulfadiazine cream is a highly efficient topical antiseptic agent for both major and minor burn wounds and that it has low toxicity. cerium nitrate-silver sulfadiazine cream can be readily employed in any clinical setting.- - - - - - - - - - ranking = 0.63240499355031keywords = shock (Clic here for more details about this article) |
8/11. wound infection and septic shock due to vibrio vulnificus.vibrio vulnificus is an organism commonly found in the marine environment whose pathogenic potential for humans has been recently recognized. Two patients are described who developed rapidly progressing wound infections and bacteremia due to this halophilic, lactose-positive vibrio. The clinical manifestations of the resulting infection differed from patterns reported by other authors.- - - - - - - - - - ranking = 4keywords = shock, septic shock (Clic here for more details about this article) |
9/11. Ultrastructural observations in an alcoholic patient with post-surgical pseudomonas infection.Gram negative bacteria were seen in the peripheral blood and within the neutrophils of a patient with bacteremic shock secondary to pseudomonas aeruginosa infection. By electron microscopy, bacteria were present either in vacuoles or in the cytoplasm of neutrophils. When seen in the cytoplasm, they were surrounded by amorphous material which most probably represented fused lysosomal granules. In both cases, the microorganisms appeared morphologically normal. The presumption is that there was a pre-existing defect of neutrophilic lysosomal formation or function. These findings indicate the importance of studying neutrophil morphology and function in patients with persistent infections.- - - - - - - - - - ranking = 0.63240499355031keywords = shock (Clic here for more details about this article) |
10/11. Toxic shock syndrome associated with use of Biobrane in a scald burn victim.Biobrane remains an excellent biosynthetic dressing for thermal injury coverage. The present report of a probable case of toxic shock syndrome associated with its use does not question its efficacy as temporary coverage for partial thickness thermal burns. Instead, attention is focused on raising the index of suspicion of toxic shock syndrome in burn patients treated with Biobrane, or other occlusive dressings, who develop early signs or symptoms which may be consistent with the diagnosis.- - - - - - - - - - ranking = 73.874307866112keywords = toxic shock syndrome, shock syndrome, toxic shock, shock (Clic here for more details about this article) |
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