Spontaneous group b streptococcal bacteremia complicating hepatic cirrhosis - Report of two cases

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Abstract

Two instances of Group B beta-hemolytic streptococcal sepsis accompanying hepatic cirrhosis are reported. The first patient is a 54-year-old female with postnecrotic cirrhosis (proved at autopsy), who manifested a primary bacteremia without a demonstrable septic focus; her infection was arrested with penicillin therapy, but she succumbed to the hemorrhagic complications of her underlying disease. The second patient, a chronic alcoholic female with probable Laennec's cirrhosis, entered in a hypothermic and leukopenic state with both a bacteremia and infected ascites; she quickly died of overwhelming sepsis despite specific therapy. It is emphasized that "primary" peritonitis and bacteremia accompanying hepatic cirrhosis are typically caused by coliform organisms and that these are presumed to be of enteric origin. The Group B Streptococcus, by contrast, is an uncommon and usually nonenteric species of low virulence that is implicated characteristically in neonatal sepsis and puerperal infection, and less commonly in diabetic gangrene. Its capacity to become a pathogen in the setting of hepatic cirrhosis is thus taken as further evidence for an as yet poorly understood defect of host defense mechanisms in this condition.

Original languageEnglish
Pages (from-to)1065-1071
Number of pages7
JournalThe American Journal of Digestive Diseases
Volume13
Issue number12
DOIs
StatePublished - Dec 1 1968
Externally publishedYes

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Bacteremia
Liver Cirrhosis
Sepsis
Fibrosis
Puerperal Infection
Streptococcus agalactiae
Gangrene
Peritonitis
Ascites
Penicillins
Virulence
Autopsy
Therapeutics
Infection

ASJC Scopus subject areas

  • Gastroenterology
  • Medicine(all)

Cite this

Spontaneous group b streptococcal bacteremia complicating hepatic cirrhosis - Report of two cases. / Ginsberg, Myron.

In: The American Journal of Digestive Diseases, Vol. 13, No. 12, 01.12.1968, p. 1065-1071.

Research output: Contribution to journalArticle

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AB - Two instances of Group B beta-hemolytic streptococcal sepsis accompanying hepatic cirrhosis are reported. The first patient is a 54-year-old female with postnecrotic cirrhosis (proved at autopsy), who manifested a primary bacteremia without a demonstrable septic focus; her infection was arrested with penicillin therapy, but she succumbed to the hemorrhagic complications of her underlying disease. The second patient, a chronic alcoholic female with probable Laennec's cirrhosis, entered in a hypothermic and leukopenic state with both a bacteremia and infected ascites; she quickly died of overwhelming sepsis despite specific therapy. It is emphasized that "primary" peritonitis and bacteremia accompanying hepatic cirrhosis are typically caused by coliform organisms and that these are presumed to be of enteric origin. The Group B Streptococcus, by contrast, is an uncommon and usually nonenteric species of low virulence that is implicated characteristically in neonatal sepsis and puerperal infection, and less commonly in diabetic gangrene. Its capacity to become a pathogen in the setting of hepatic cirrhosis is thus taken as further evidence for an as yet poorly understood defect of host defense mechanisms in this condition.

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