Raghda Marzaban1, Maged Salah2, Ahmed M Mukhtar2, Reham A Dwedar3, Walaa Abdel-Latif4, Ihab Mahmoud5. 1. Department of Endemic Medicine and Hepatogastroenterology, Faculty of Medicine, Cairo University, Cairo, Egypt. 2. Department of Anaesthesia and Intensive Care, Faculty of Medicine, Cairo University, Cairo, Egypt. 3. Department of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, Cairo, Egypt. 4. Department of Medical Microbiology and Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. 5. Department of Intensive Care, Wady El-Nile hospital, Cairo, Egypt.
Abstract
BACKGROUND: Fungal infections have a significant impact on patient survival after liver transplantation, mostly caused by Candida and Aspergillus. The clinical manifestations vary, and range from colonization, active local infection, to severe invasive form. A high degree of suspicion is required for the early diagnosis and, accordingly, the optimal management of these infections. This study aimed to evaluate fungal infection in the Intensive care Unit (ICU) in admitted liver transplant patients, focussing of etiologic agent, clinical/laboratory presentation (including mortality), and risk factors. MATERIAL AND METHODS: This retrospective study included living related liver transplanted patients admitted to the ICU. Clinical data was collected, thorough clinical evaluation was done, and laboratory tests were performed. Microbiological examination detecting the presence of fungus in various samples, using cultures and serology, and imaging investigations were carried out in all patients. RESULTS: This study included 23 cases of ICU-admitted liver transplant patients who were diagnosed with fungal infection. Candida was the most common fungal infection and occurred at a mean of 2 months after transplantation; while Aspergillus was less common and occurred later with worse laboratory findings. Invasive fungal infection constituted 43% of the diagnosed cases. Difference in mortality between Aspergillus and Candida was insignificant, as was difference between patients with and without fungal infection. CONCLUSIONS: Fungal infection among LT patients was common, including the invasive forms.
BACKGROUND:Fungal infections have a significant impact on patient survival after liver transplantation, mostly caused by Candida and Aspergillus. The clinical manifestations vary, and range from colonization, active local infection, to severe invasive form. A high degree of suspicion is required for the early diagnosis and, accordingly, the optimal management of these infections. This study aimed to evaluate fungal infection in the Intensive care Unit (ICU) in admitted liver transplant patients, focussing of etiologic agent, clinical/laboratory presentation (including mortality), and risk factors. MATERIAL AND METHODS: This retrospective study included living related liver transplanted patients admitted to the ICU. Clinical data was collected, thorough clinical evaluation was done, and laboratory tests were performed. Microbiological examination detecting the presence of fungus in various samples, using cultures and serology, and imaging investigations were carried out in all patients. RESULTS: This study included 23 cases of ICU-admitted liver transplant patients who were diagnosed with fungal infection. Candida was the most common fungal infection and occurred at a mean of 2 months after transplantation; while Aspergillus was less common and occurred later with worse laboratory findings. Invasive fungal infection constituted 43% of the diagnosed cases. Difference in mortality between Aspergillus and Candida was insignificant, as was difference between patients with and without fungal infection. CONCLUSIONS:Fungal infection among LT patients was common, including the invasive forms.