BACKGROUND: Severe alcoholic hepatitis (AH) has a poor short-term prognosis often caused by infections. However, the incidence of invasive mycosis in patients with AH treated with corticosteroids and its impact still remains unknown. METHODS: Retrospective analyses of twelve medical ICU patients (out of 120 patients with liver cirrhosis) with histological proven AH. RESULTS: Twelve patients were diagnosed with histological proven AH during there stay at the ICU. All patients were treated with corticosteroids; three patients were treated with corticosteroids and pentoxifylline. Five patients had invasive aspergillosis (IA); three patients had candidemia; and two had fungal colonization with candida species. Only two patients had no evidence for fungals. IA was associated with death in all cases. Death occured in most cases shortly after diagnosis despite antifungal medication. Two patients with candidemia died; one patient died in the group with fungal colonization. Overall, the mortality rate was 100% in patients with IA and 70% in the group with candidemia. CONCLUSIONS: Patients with severe AH have an increased susceptibility to invasive mycosis associated with high mortality. A high level of suspicion of invasive mycosis in AH patients and prophylactic strategies are needed in those patients.
BACKGROUND: Severe alcoholic hepatitis (AH) has a poor short-term prognosis often caused by infections. However, the incidence of invasive mycosis in patients with AH treated with corticosteroids and its impact still remains unknown. METHODS: Retrospective analyses of twelve medical ICU patients (out of 120 patients with liver cirrhosis) with histological proven AH. RESULTS: Twelve patients were diagnosed with histological proven AH during there stay at the ICU. All patients were treated with corticosteroids; three patients were treated with corticosteroids and pentoxifylline. Five patients had invasive aspergillosis (IA); three patients had candidemia; and two had fungal colonization with candida species. Only two patients had no evidence for fungals. IA was associated with death in all cases. Death occured in most cases shortly after diagnosis despite antifungal medication. Two patients with candidemia died; one patient died in the group with fungal colonization. Overall, the mortality rate was 100% in patients with IA and 70% in the group with candidemia. CONCLUSIONS:Patients with severe AH have an increased susceptibility to invasive mycosis associated with high mortality. A high level of suspicion of invasive mycosis in AHpatients and prophylactic strategies are needed in those patients.
Authors: Philippe Mathurin; Charles L Mendenhall; Robert L Carithers; Marie-Jose Ramond; Willis C Maddrey; Peter Garstide; Bernard Rueff; Sylvie Naveau; Jean-Claude Chaput; Thierry Poynard Journal: J Hepatol Date: 2002-04 Impact factor: 25.083
Authors: Thomas J Walsh; Elias J Anaissie; David W Denning; Raoul Herbrecht; Dimitrios P Kontoyiannis; Kieren A Marr; Vicki A Morrison; Brahm H Segal; William J Steinbach; David A Stevens; Jo-Anne van Burik; John R Wingard; Thomas F Patterson Journal: Clin Infect Dis Date: 2008-02-01 Impact factor: 9.079
Authors: Jasmohan S Bajaj; Rajender K Reddy; Puneeta Tandon; Florence Wong; Patrick S Kamath; Scott W Biggins; Guadalupe Garcia-Tsao; Michael Fallon; Benedict Maliakkal; Jennifer Lai; Hugo E Vargas; Ram M Subramanian; Paul Thuluvath; Leroy R Thacker; Jacqueline G OʼLeary Journal: Am J Gastroenterol Date: 2017-12-19 Impact factor: 10.864
Authors: Siang Fei Yeoh; Tae Jin Lee; Ka Lip Chew; Stephen Lin; Dennis Yeo; Sajita Setia Journal: Infect Drug Resist Date: 2018-05-30 Impact factor: 4.003