Invasive fungal infections secondary to acute-on-chronic liver failure: a retrospective study

Mycoses ◽  
2013 ◽  
Vol 56 (4) ◽  
pp. 429-433 ◽  
Author(s):  
Li Na Lin ◽  
Yu Zhu ◽  
Fu Bin Che ◽  
Ju Lin Gu ◽  
Jiang Han Chen
Keyword(s):  
Retrospective Study ◽  
Liver Failure ◽  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Chronic Liver ◽  
Chronic Liver Failure

Invasive Fungal Infections in Patients of Acute on Chronic Liver Failure

2016 ◽  
Vol 6 ◽  
pp. S2-S3
Author(s):  
Nipun Verma ◽  
Shreya Singh ◽  
Sunil Taneja ◽  
Shiva Prakash ◽  
Arunaloke Chakarbarti ◽  
...  
Keyword(s):  
Liver Failure ◽  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Chronic Liver ◽  
Chronic Liver Failure

Invasive fungal infections amongst patients with acute-on-chronic liver failure at high risk for fungal infections

2018 ◽  
Vol 39 (3) ◽  
pp. 503-513 ◽  
Author(s):  
Nipun Verma ◽  
Shreya Singh ◽  
Sunil Taneja ◽  
Ajay Duseja ◽  
Virendra Singh ◽  
...  
Keyword(s):  
High Risk ◽  
Liver Failure ◽  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Chronic Liver ◽  
Chronic Liver Failure

scholarly journals Bacterial and fungal infections in acute-on-chronic liver failure: prevalence, characteristics and impact on prognosis

Gut ◽  
2017 ◽  
Vol 67 (10) ◽  
pp. 1870-1880 ◽  
Author(s):  
Javier Fernández ◽  
Juan Acevedo ◽  
Reiner Wiest ◽  
Thierry Gustot ◽  
Alex Amoros ◽  
...  
Keyword(s):  
Liver Failure ◽  
Systemic Inflammation ◽  
Bacterial Infections ◽  
Clinical Course ◽  
Fungal Infections ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Bacterial Peritonitis ◽  
Probability Of Survival

Bacterial infection is a frequent trigger of acute-on-chronic liver failure (ACLF), syndrome that could also increase the risk of infection. This investigation evaluated prevalence and characteristics of bacterial and fungal infections causing and complicating ACLF, predictors of follow-up bacterial infections and impact of bacterial infections on survival.Patients407 patients with ACLF and 235 patients with acute decompensation (AD).Results152 patients (37%) presented bacterial infections at ACLF diagnosis; 46%(n=117) of the remaining 255 patients with ACLF developed bacterial infections during follow-up (4 weeks). The corresponding figures in patients with AD were 25% and 18% (p<0.001). Severe infections (spontaneous bacterial peritonitis, pneumonia, severe sepsis/shock, nosocomial infections and infections caused by multiresistant organisms) were more prevalent in patients with ACLF. Patients with ACLF and bacterial infections (either at diagnosis or during follow-up) showed higher grade of systemic inflammation at diagnosis of the syndrome, worse clinical course (ACLF 2-3 at final assessment: 47% vs 26%; p<0.001) and lower 90-day probability of survival (49% vs 72.5%;p<0.001) than patients with ACLF without infection. Bacterial infections were independently associated with mortality in patients with ACLF-1 and ACLF-2. Fungal infections developed in 9 patients with ACLF (2%) and in none with AD, occurred mainly after ACLF diagnosis (78%) and had high 90-day mortality (71%).ConclusionBacterial infections are extremely frequent in ACLF. They are severe and associated with intense systemic inflammation, poor clinical course and high mortality. Patients with ACLF are highly predisposed to develop bacterial infections within a short follow-up period and could benefit from prophylactic strategies.

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