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Published in: BMC Gastroenterology 1/2008

Open Access 01-12-2008 | Research article

Hospital-acquired invasive pulmonary aspergillosis in patients with hepatic failure

Authors: Dan Li, Liang Chen, Xian Ding, Ran Tao, Yong Xin Zhang, Jie Fei Wang

Published in: BMC Gastroenterology | Issue 1/2008

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Abstract

Background

Invasive pulmonary aspergillosis (IPA) is a rapid, progressive, fatal disease that occurs mostly in immunocompromised patients. Patients with severe liver disease are at a heightened risk for infections. Little is known about the clinical presentation including predisposing factors and treatment of IPA in patients with hepatic failure.

Methods

Medical records of patients with hepatic failure between November 2005 and February 2007 were reviewed for lung infection. Nine medical records of definitive diagnosis of IPA and three of probable IPA were identified.

Results

The main predisposing factors were found to be prolonged antibiotic therapy and steroid exposure. Clinical signs and radiological findings were non-specific and atypical. Timely use of caspofungin was found to reduce the mortality due to the disease.

Conclusion

A high index of suspicion is required for early IPA diagnosis in patients with hepatic failure.
Literature
1.
go back to reference Trof RJ, Beishuizen A, Debets-Ossenkopp YJ, Girbes AR, Groeneveld AB: Management of invasive pulmonary aspergillosis in non-neutropenic critically ill patients. Intensive Care Med. 2007, 33: 1694-1703. 10.1007/s00134-007-0791-z.CrossRefPubMedPubMedCentral Trof RJ, Beishuizen A, Debets-Ossenkopp YJ, Girbes AR, Groeneveld AB: Management of invasive pulmonary aspergillosis in non-neutropenic critically ill patients. Intensive Care Med. 2007, 33: 1694-1703. 10.1007/s00134-007-0791-z.CrossRefPubMedPubMedCentral
2.
go back to reference Sharma OP, Chwogule R: Many faces of pulmonary aspergillosis. Eur Respir J. 1998, 12: 705-715. 10.1183/09031936.98.12030705.CrossRefPubMed Sharma OP, Chwogule R: Many faces of pulmonary aspergillosis. Eur Respir J. 1998, 12: 705-715. 10.1183/09031936.98.12030705.CrossRefPubMed
4.
go back to reference Perfect JR, Cox GM, Lee JY, Kauffman CA, de Repentigny L, Chapman SW, Morrison VA, Pappas V, Hiemenz JW, Stevens DA: The impact of culture isolation of Aspergillus species: a hospital-based survey of aspergillosis. Clin Infect Dis. 2001, 33: 1824-1833. 10.1086/323900.CrossRefPubMed Perfect JR, Cox GM, Lee JY, Kauffman CA, de Repentigny L, Chapman SW, Morrison VA, Pappas V, Hiemenz JW, Stevens DA: The impact of culture isolation of Aspergillus species: a hospital-based survey of aspergillosis. Clin Infect Dis. 2001, 33: 1824-1833. 10.1086/323900.CrossRefPubMed
5.
go back to reference El-Serag HB, Anand B, Richardson P, Rabeneck L: Association between hepatitis C infection and other infectious disease: a case for targeted screening?. AM J Gastroentero. 2003, 98: 167-174. 10.1111/j.1572-0241.2003.07176.x.CrossRef El-Serag HB, Anand B, Richardson P, Rabeneck L: Association between hepatitis C infection and other infectious disease: a case for targeted screening?. AM J Gastroentero. 2003, 98: 167-174. 10.1111/j.1572-0241.2003.07176.x.CrossRef
6.
go back to reference Yakoob J, Jafri W, Hussainy AS: Candida oesophagitis with hepatitis C virus: an uncommon association. Eur J Gastroenterol Hepato. 2003, 15: 701-703. 10.1097/00042737-200306000-00019.CrossRef Yakoob J, Jafri W, Hussainy AS: Candida oesophagitis with hepatitis C virus: an uncommon association. Eur J Gastroenterol Hepato. 2003, 15: 701-703. 10.1097/00042737-200306000-00019.CrossRef
7.
go back to reference Ascioglu S, Rex JH, de Pauw B, Bennett JE, Bille J, Crokaert F, Denning DW, Donnelly JP, Edwards JE, Erjavec Z, Fiere D, Lortholary O, Maertens J, Meis JF, Patterson TF, Ritter J, Selleslag D, Shah PM, Stevens DA, Walsh TJ, Invasive Fungal Infections Cooperative Group of the European Organization for Research and Treatment of Cancer; Mycoses Study Group of the National Institute of Allergy and Infectious Diseases: Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus. Clin Infect Dis. 2002, 34: 7-14. 10.1086/323335.CrossRefPubMed Ascioglu S, Rex JH, de Pauw B, Bennett JE, Bille J, Crokaert F, Denning DW, Donnelly JP, Edwards JE, Erjavec Z, Fiere D, Lortholary O, Maertens J, Meis JF, Patterson TF, Ritter J, Selleslag D, Shah PM, Stevens DA, Walsh TJ, Invasive Fungal Infections Cooperative Group of the European Organization for Research and Treatment of Cancer; Mycoses Study Group of the National Institute of Allergy and Infectious Diseases: Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus. Clin Infect Dis. 2002, 34: 7-14. 10.1086/323335.CrossRefPubMed
8.
go back to reference Caillot D, Casasnovas O, Bernard A, Couaillier JF, Durand C, Cuisenier B, Solary E, Piard F, Petrella T, Bonnin A, Couillault G, Dumas M, Guy H: Improved management of invasive pulmonary aspergillosis in neutropenic patients using early thoracic computed tomographic scan and surgery. J Clin Oncol. 1997, 15: 139-147.PubMed Caillot D, Casasnovas O, Bernard A, Couaillier JF, Durand C, Cuisenier B, Solary E, Piard F, Petrella T, Bonnin A, Couillault G, Dumas M, Guy H: Improved management of invasive pulmonary aspergillosis in neutropenic patients using early thoracic computed tomographic scan and surgery. J Clin Oncol. 1997, 15: 139-147.PubMed
10.
go back to reference Huifen Wang: Emphasis on the diagnosis and treatment of deep fungal infection in patients with severe hepatic disease. Infect Dis Info. 2006, 19: 166-167. Huifen Wang: Emphasis on the diagnosis and treatment of deep fungal infection in patients with severe hepatic disease. Infect Dis Info. 2006, 19: 166-167.
11.
go back to reference Yunping Huang, Miaoer Huang, Hua Chen, Xueying Yang: Fungus infection and differential leukocyte count: relation between them. Chin J Nosocomiol. 2006, 16: 630-632. Yunping Huang, Miaoer Huang, Hua Chen, Xueying Yang: Fungus infection and differential leukocyte count: relation between them. Chin J Nosocomiol. 2006, 16: 630-632.
12.
go back to reference Prodanovic H, Cracco C, Massard J, Massard J, Barrault C, Thabut D, Duguet A, Datry A, Derenne JP, Poynard T, Similowski T: Invasive pulmonary aspergillosis in patients with decompensated cirrhosis: case series. BMC Gastroenterol. 2007, 7: 2-10.1186/1471-230X-7-2.CrossRefPubMedPubMedCentral Prodanovic H, Cracco C, Massard J, Massard J, Barrault C, Thabut D, Duguet A, Datry A, Derenne JP, Poynard T, Similowski T: Invasive pulmonary aspergillosis in patients with decompensated cirrhosis: case series. BMC Gastroenterol. 2007, 7: 2-10.1186/1471-230X-7-2.CrossRefPubMedPubMedCentral
13.
go back to reference Vandewoude KH, Blot SI, Depuydt P, Depuydt P, Benoit D, Temmerman W, Colardyn F, Vogelaers D: Clinical relevance of Aspergillus isolation from respiratory tract samples in critically ill patients. Crit Care. 2006, 10: R31-10.1186/cc4823.CrossRefPubMedPubMedCentral Vandewoude KH, Blot SI, Depuydt P, Depuydt P, Benoit D, Temmerman W, Colardyn F, Vogelaers D: Clinical relevance of Aspergillus isolation from respiratory tract samples in critically ill patients. Crit Care. 2006, 10: R31-10.1186/cc4823.CrossRefPubMedPubMedCentral
Metadata
Title
Hospital-acquired invasive pulmonary aspergillosis in patients with hepatic failure
Authors
Dan Li
Liang Chen
Xian Ding
Ran Tao
Yong Xin Zhang
Jie Fei Wang
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2008
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/1471-230X-8-32

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