Comparison of Initial and Postlavage Bacterial Culture Results of Septic Peritonitis in Dogs and Cats

2018 ◽  
Vol 54 (5) ◽  
pp. 257-266
Author(s):  
Sarah Ruth Kalafut ◽  
Pamela Schwartz ◽  
Rachael Leigh Currao ◽  
Andrew Scott Levien ◽  
George E. Moore
Keyword(s):  
Peritoneal Lavage ◽  
Positive Culture ◽  
Source Control ◽  
Bacterial Isolates ◽  
Common Life ◽  
Significant Difference ◽  
Septic Peritonitis ◽  
Threatening Condition ◽  
Life Threatening ◽  
Susceptibility Profiles

ABSTRACT Septic peritonitis is a common, life-threatening condition encountered in dogs and cats. Efficacy of peritoneal lavage has not been proven in veterinary studies. Our objective was to evaluate differences in bacterial identity and susceptibility in samples obtained pre- and postlavage in animals who underwent laparotomy for treatment of septic peritonitis and to assess the effect of empirical antimicrobial selection on survival. Culture samples were collected from the peritoneal surface pre- and postlavage from dogs and cats treated surgically for septic peritonitis. Culture results were compared for each patient with regard to bacterial isolates and bacterial susceptibility profiles. Survival to discharge was evaluated. Microbial growth occurred in at least one culture in 88.6% of patients. There was no significant difference in bacterial isolates or susceptibility profiles pre- versus postlavage. Positive culture pre- or postlavage and appropriate antimicrobial selection did not significantly affect survival. For individual animals, culture results differed between pre- and postlavage samples, although no definitive effect of peritoneal lavage was seen for the population as a whole. Antimicrobials most commonly effective against isolates were Cefotaxime, Ceftazidime, and Imipenem. If prompt surgical source control is employed, antibiotic choice may not affect clinical outcome.

Diverting Loop Ileostomy for Clostridium Difficile Colitis: A Systematic Review and Meta-analysis

2020 ◽  
Vol 86 (10) ◽  
pp. 1269-1276
Author(s):  
Adam D. Shellito ◽  
Marcia M. Russell
Keyword(s):  
Clostridium Difficile ◽  
Meta Analysis ◽  
Loop Ileostomy ◽  
Patient Characteristics ◽  
Specific Patient ◽  
Entire Cohort ◽  
Significant Difference ◽  
Threatening Condition ◽  
Life Threatening ◽  
Diverting Loop Ileostomy

Diverting loop ileostomy (DLI) with colonic lavage has been proposed as an alternative to total abdominal colectomy (TAC) for fulminant Clostridium difficile infection (CDI). Controversy exists regarding the mortality benefit and outcomes of this surgical approach. We conducted a MEDLINE database search for articles between 1999 and 2019 pertaining to DLI for the surgical treatment of CDI. Five articles met the inclusion criteria. Four studies were retrospective and one was a prospective matched cohort study. 3683 patients were included in the 5 studies; 733 patients (20%) underwent DLI, while 2950 patients (80%) underwent TAC. The only shared outcome measure across all 5 studies was mortality. The overall mortality rate for the entire cohort undergoing both procedures was 30.3%. There was no statistically significant difference in pooled mortality between DLI and TAC (OR: .73; 95% CI, .45-1.2; P = .22). Reporting of other postoperative outcomes was variable. Fulminant CDI remains a life-threatening condition with high mortality. Loop ileostomy may be a viable surgical alternative to total colectomy with similar mortality; however, further work is needed to determine specific patient characteristics that warrant routine use of DLI.

Effect of peritoneal lavage on bacterial isolates in 40 dogs with confirmed septic peritonitis

2019 ◽  
Vol 29 (6) ◽  
pp. 635-642
Author(s):  
Hannah Marshall ◽  
Virginia Sinnott‐Stutzman ◽  
Patty Ewing ◽  
Kiko Bracker ◽  
Russell Kalis ◽  
...  
Keyword(s):  
Peritoneal Lavage ◽  
Bacterial Isolates ◽  
Septic Peritonitis

Peritoneallavage bei septischer Peritonitis des Hundes

2020 ◽  
Vol 48 (01) ◽  
pp. 57-58
Author(s):  
Daniela Simon Betz
Keyword(s):  
Peritoneal Lavage ◽  
Bacterial Isolates ◽  
Septic Peritonitis

Marshall H, Sinnott-Stutzman V, Ewing P et al. Effect of peritoneal lavage on bacterial isolates in 40 dogs with confirmed septic peritonitis. J Vet Emerg Crit Care 2019; 29 (6): 635–642 Septische Peritonitis (SP) ist eine Infektion der Peritonealhöhle, die häufig durch eine Ruptur im Bereich des Gastrointestinal-, Hepatobiliär- oder Urogenitaltrakts bedingt ist. In der Humanmedizin gilt eine Peritoneallavage (PL) bei SP als nicht unumstritten, stellt dennoch eine häufig angewandte Behandlungsmethode dar. Bei Hunden mit SP liegen nur wenige Erkenntnisse zur Zusammensetzung des bakteriellen Spektrums und der Antibiotika-Resistenzlage bzw. deren Veränderung im Verlauf einer PL vor. Ziel dieser Studie war, die mikrobiologische Zusammensetzung, die Antibiotikasensitivität und das Antibiotika-Resistenzmuster der Bakterien in der Bauchhöhlenflüssigkeit von Hunden mit SP vor und nach einer PL zu untersuchen.

scholarly journals Sepsis: source control

2021 ◽  
Vol 18 (5) ◽  
pp. 89-96
Author(s):  
V. V. Kulabukhov ◽  
N. A. Zubareva ◽  
P. A. Yartsev
Keyword(s):  
Successful Treatment ◽  
Randomized Trials ◽  
Source Control ◽  
Optimal Timing ◽  
Source Of Infection ◽  
Threatening Condition ◽  
Life Threatening ◽  
The Moment ◽  
Sepsis And Septic Shock ◽  
Time Of Intervention

Sepsis is a life-threatening condition, which is manifested by the development of organ dysfunction due to generalized inflammation caused by the infection of various nature. Timely lesion debridement combined with adequate antibiotic therapy are important components of the successful treatment of sepsis. At the moment, there is no consensus about the volume and time of intervention in the development of surgical sepsis. The article discusses modern approaches to solving the problem of adequate sanitation of the source of infection. The results of few randomized trials in this area are presented.Source control is absolutely essential for the successful treatment of sepsis. However, it is difcult to create a unifed algorithm for surgical control for all cases due to different approaches depending on the infection location. Properly designed clinical trials are necessary to determine the optimal timing of surgery for sepsis and septic shock as least.

How I treat warfarin-associated coagulopathy in patients with intracerebral hemorrhage

Blood ◽  
2011 ◽  
Vol 117 (23) ◽  
pp. 6091-6099 ◽  
Author(s):  
Lawrence Tim Goodnough ◽  
Aryeh Shander
Keyword(s):  
Intracerebral Hemorrhage ◽  
Clinical Care ◽  
Relevant Literature ◽  
Coagulation Factor ◽  
Optimal Dose ◽  
Prothrombin Complex Concentrates ◽  
Plasma Therapy ◽  
Common Life ◽  
Threatening Condition ◽  
Life Threatening

Abstract Intracerebral hemorrhage in patients with warfarin-associated coagulopathy is an increasingly common life-threatening condition that requires emergent management. The evolution of therapeutic options in this setting, as well as recently published guidelines, has resulted in some heterogeneity in recommendations by professional societies. This heterogeneity can be attributed to lack of evidence-based support for plasma therapy; the variability in availability of prothrombin complex concentrates; the variability in the coagulation factor levels and contents of prothrombin complex concentrates; ambiguity about the optimal dose and route of administration of vitamin K; and the lack of standardized clinical care pathways, particularly in community hospitals, for the management of these critical care patients. In this review, we summarize the relevant literature about these controversies and present recommendations for management of patients with warfarin-associated coagulopathy and intracerebral hemorrhage.

Successful treatment of uterine torsion and fetal retention in a postparturient Great Pyrenees bitch with septic peritonitis and prothrombotic complications

1997 ◽  
Vol 33 (6) ◽  
pp. 537-539 ◽  
Author(s):  
MG Ritt ◽  
TW Fossum
Keyword(s):  
Septic Shock ◽  
Medical Therapy ◽  
Successful Treatment ◽  
Successful Outcome ◽  
Gravid Uterus ◽  
Medical Complications ◽  
Uterine Torsion ◽  
Septic Peritonitis ◽  
Threatening Condition ◽  
Life Threatening

The treatment and favorable outcome of a bitch with uterine torsion and two retained fetuses are described. The condition was corrected surgically by ovariohysterectomy. Complications (i.e., septic shock, peritonitis, and hemostatic abnormalities) were managed with aggressive medical therapy. Torsion of the gravid uterus in dogs is a life-threatening condition which can have a successful outcome if medical complications encountered in the pre- and postoperative periods are treated quickly and effectively.

Venous Thromboembolic Disease

2008 ◽  
Vol 6 (8) ◽  
pp. 716 ◽  
Author(s):  
_ _
Keyword(s):  
Cancer Patients ◽  
Perceived Risk ◽  
Common Life ◽  
Nccn Guidelines ◽  
Patients With Cancer ◽  
Venous Thromboembolic ◽  
Threatening Condition ◽  
Life Threatening ◽  
Risk For Bleeding ◽  
Work Up

Venous thromboembolism (VTE) is a common, life-threatening condition in patients with cancer, which includes both deep venous thrombosis (DVT) and pulmonary embolism. The occurrence of VTE has been reported to increase the likelihood of death for cancer patients by 2- to 8-fold. Pathophysiologic explanations for VTE in cancer include known hypercoagulability, vessel wall damage, and vessel stasis from direct compression, and the incidence of VTE in cancer is increased by additional risks factors. The NCCN guidelines specifically outline strategies to prevent and treat VTE in adult cancer patients. These guidelines are characterized by evaluations of the therapeutic advantages of pharmacologic anticoagulation measures based on both perceived risk for bleeding (i.e., contraindications to anticoagulation) and cancer status. Important updates for 2008 include new work-up recommendations and changes in the recommendations for outpatient prophylaxis and diagnosis and for treatment of heparin-induced thrombocytopenia. For the most recent version of the guidelines, please visit NCCN.org

May-Thurner syndrome – Are we aware enough?

VASA ◽  
2019 ◽  
Vol 48 (5) ◽  
pp. 381-388 ◽  
Author(s):  
Katalin Mako ◽  
Attila Puskas
Keyword(s):  
Contraceptive Use ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Compression Syndrome ◽  
Threatening Condition ◽  
Life Threatening ◽  
Iliac Vein Compression ◽  
Iliac Vein Compression Syndrome ◽  
The Right

Summary. Iliac vein compression syndrome (May-Thurner syndrome – MTS) is an anatomically variable clinical condition in which the left common iliac vein is compressed between the right common iliac artery and the underlying spine. This anatomic variant results in an increased incidence of left iliac or iliofemoral vein thrombosis. It predominantly affects young women in the second or third decades of life with preponderance during pregnancy or oral contraceptive use. Although MTS is rare, its true prevalence is underestimated but it can be a life-threatening condition due to development of pulmonary embolism (PE). In this case based review the authors present three cases of MTS. All patients had been previously confirmed with PE, but despite they were admitted to hospital, diagnosed and correctly treated for PE and investigated for thrombophilia, the iliac vein compression syndrome was not suspected or investigated. With this presentation the authors would like to emphasize that MTS is mostly underdiagnosed, and it needs to be ruled out in left iliofemoral vein thrombosis in young individuals.

Severe Alveolar Hemorrhage – What’s in it for the Gastroenterologist?

2016 ◽  
Vol 25 (4) ◽  
pp. 555-558
Author(s):  
Alina Popp
Keyword(s):  
Celiac Disease ◽  
International Normalized Ratio ◽  
Gluten Free Diet ◽  
Alveolar Hemorrhage ◽  
Severe Anemia ◽  
Gluten Free ◽  
Pulmonary Infiltrates ◽  
Pulmonary Hemosiderosis ◽  
Threatening Condition ◽  
Life Threatening

Background: Alveolar hemorrhage is a potentially life-threatening condition which is usually managed by the pulmonologist. When considering its etiology, there is a rare association that sets the disease into the hands of the gastroenterologist. Case presentation: We report the case of a 48 year-old female who was admitted to the intensive care unit for severe anemia and hemoptysis. On imaging, diffuse pulmonary infiltrates suggestive of alveolar hemorrhage were detected and a diagnosis of pulmonary hemosiderosis was made. She received cortisone therapy and hematologic correction of anemia, with slow recovery. In search of an etiology for the pulmonary hemosiderosis, an extensive workup was done, and celiac disease specific serology was found positive. After confirmation of celiac disease by biopsy, a diagnosis of Lane-Hamilton syndrome was established. The patient was recommended a gluten-free diet and at 6 months follow-up, resolution of anemia and pulmonary infiltrates were observed. Conclusion: Although the association is rare, celiac disease should be considered in a patient with idiopathic pulmonary hemosiderosis. In our case, severe anemia and alveolar infiltrates markedly improved with glucocorticoids and gluten-free diet. Abbreviations: APTT: activated partial thromboplastin time; BAL: bronchoalveolar lavage; CD: celiac disease; Cd: crypt depth; GFD: gluten-free diet; GI: gastrointestinal; IEL: intraepithelial lymphocyte; INR: international normalized ratio; IPH: idiopathic pu

Determination some Immunological Aspects in Pulmonary Tuberculosis Patients in Qadisiyah Province

2018 ◽  
Vol 9 (2) ◽  
Author(s):  
Syoof Khowman Alramahy ◽  
Akram Hadi Hamza
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Statistical Difference ◽  
Positive Culture ◽  
Control Group ◽  
Tuberculosis Patients ◽  
Significant Difference ◽  
Lowenstein Jensen ◽  
The Mean ◽  
Igg Level

This study was carried out to study of some immunological aspects among the pulmonary Tuberculosis patients infected with causative agent, Mycobacterium tuberculosis. A Total of 200 sputum samples were collected from patients attending the consultant Clinic for Chest and Respiratory disease center, Diwaniya. Control group (No=15) also included. According to acid fast stain of sputum, the patients were classified as positive (No=91,45.5%) and negative (No=109,54.5, Lowenstein Jensen medium used for the cultivation of samples, on which 70% of sputum samples where positive culture for this microorganism. The grown microorganism were identified as M. tuberculosis, based on positive A.F.B, Niacin producers ,negative for catlase at 68c. The mean IgG level was l184.053±76.684 mg/100 ml in tuberculosis group compared with 1016.533 ± 44.882 mg/100ml in control group, rendering the statistical difference significant. For IgA and IgM levels, they were at mean of 315.880±38.552 mg/100 ml and 119.527±8.464 mg/100 ml in control group compared with 396.358±38.776 mg/100 ml and 134.207±11.696 mg/100 ml in patients group respectively with significant difference

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