pituitrin and Staphylococcal-Infections

Topics: Child, Preschool; Female; Fontan Procedure; Heart Defects, Congenital; Humans; Hypotension; Mediastinitis; Shock, Septic; Staphylococcal Infections; Surgical Wound Infection; Vascular Resistance; Vasoconstrictor Agents; Vasopressins

To describe the utility of vasopressin in the treatment of acute distributive shock clinically compatible with the diagnosis of aprotinin anaphylaxis.. A 57-yr-old female patient underwent repeat cardiac surgery to treat prosthetic valve endocarditis. She had received aprotinin during her first surgery 60 days ago. Despite a negative test dose of i.v. aprotinin 20,000 KIU, when aprotinin loading was initiated during the repeat surgery, the patient developed bronchospasm and hypotension secondary to acute distributive shock. Bronchospasm responded to inhaled salbutamol and ipatropium. The hypotension was refractory to high doses of phenylephrine. Two doses of i.v. vasopressin 5 U reversed the vasodilation and reestablished normal blood pressure.. Vasopressin, in association with alpha-agonists, can reverse acute refractory distributive shock following aprotinin administration.

Topics: Aprotinin; Blood Pressure; Bronchial Spasm; Cardiac Output; Cardiac Surgical Procedures; Central Venous Pressure; Endocarditis; Female; Heart Rate; Heart Valve Prosthesis; Hemostatics; Humans; Hypotension; Middle Aged; Prosthesis Failure; Reoperation; Shock; Staphylococcal Infections; Vasoconstrictor Agents; Vasopressins

Topics: Brain Abscess; Brain Injuries; Enterococcus faecalis; Follow-Up Studies; Humans; Male; Meningitis; Military Medicine; Postoperative Complications; Prospective Studies; Pulmonary Embolism; Staphylococcal Infections; Streptococcal Infections; Surgical Wound Dehiscence; Surgical Wound Infection; Transportation of Patients; United States; Vasopressins; Vietnam; Warfare; Wounds, Gunshot

The effect of early bilateral pyelonephritis on urinary concentrating ability was studied in rats injected intravenously with enterococci or Staphylococcus aureus and in rats inoculated with Escherichia coli into the medullae of both kidneys. The mean maximum urinary osmolality of normal rats was 2352 mOsm/kg of water. Inoculation of E. coli caused reversible pyelonephritis with sterilization of the kidneys within 12 wk. By 1 day after injection the mean maximum urinary osmolality had decreased to about 1100 mOsm. remained at this level for 3 wk, and then rose to normal by 12 wk. After injection of enterococci and staphylococci, the mean maximum urine osmolality decreased over 3-4 days to about 1000 and 800 mOsm respectively. In the enterococcal infection (which is chronic) the maximum urine osmolality remained about 1200 mOsm for at least 12 wk whereas in the staphylococcal infection (which is reversible) the osmolality gradually rose. Antimicrobial therapy of E. coli renal infection with colistimethate sodium and S. aureus infection with ampicillin rapidly reduced bacterial titers in the kidneys with an associated rise in maximum urinary osmolality. Therapy of enterococcal renal infection with ampicillin produced less impressive decreases in bacterial titers in the kidneys and little or no improvement in urinary concentrating ability. With antimicrobial therapy or with the self-limited infections, the rate of increase in concentrating ability was directly correlated with the rate of decrease of bacterial titers. However, there was poor correlation between histological findings in the kidneys and urinary concentrating ability. These studies demonstrate that early experimental pyelonephritis is associated with a concentrating defect that can be rapidly reversed and therefore is not related to permanent renal damage.

Topics: Ampicillin; Animals; Anti-Bacterial Agents; Colistin; Creatinine; Escherichia coli Infections; Kidney; Kidney Concentrating Ability; Male; Osmolar Concentration; Pyelonephritis; Rats; Staphylococcal Infections; Streptococcal Infections; Vasopressins

Topics: Cephalothin; Chloramphenicol; Humans; Hypokalemia; Male; Meningoencephalitis; Middle Aged; Oxacillin; Penicillin G; Penicillin Resistance; Polyuria; Potassium; Sepsis; Staphylococcal Infections; Vancomycin; Vasopressins

Topics: Aged; Aging; Alcaligenes; Aminohippuric Acids; Bacteriuria; Escherichia coli Infections; Female; Glomerular Filtration Rate; Humans; Infusions, Parenteral; Inulin; Kidney; Kidney Concentrating Ability; Kidney Function Tests; Klebsiella Infections; Male; Methods; Pseudomonas Infections; Staphylococcal Infections; Urinary Catheterization; Urinary Tract Infections; Vasopressins

Topics: Colistin; Humans; Kidney Function Tests; Male; Pharmacology; Pseudomonas Infections; Pyelonephritis; Radioisotopes; Radionuclide Imaging; Staphylococcal Infections; Urography; Vasopressins