Acta clinica Belgica · 2013
Invasive aspergillosis in patients with cirrhosis, a case report and review of the last 10 years.
Клинический случайСтатьяОбзорНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Jeurissen S, Vogelaers D, Sermijn E, Van Dycke K, Geerts A, Van Vlierberghe H, Colle I
Аннотация
BACKGROUND: Untreated invasive aspergillosis (IA) is lethal, yet diagnosis is often delayed. Recognising the risk factors can lead to earlier diagnosis. We present a case of an invasive pulmonary aspergillosis in a patient with cirrhosis, who had been treated with corticosteroids for 2.5 weeks for alcoholic hepatitis. He was successfully treated with liposomal amphotericin B and caspofungin (first in combination, then caspofungin monotherapy).
PURPOSE: To evaluate the role of aspergillosis in cirrhosis.
METHODS: A literature search on aspergillosis in cirrhosis and liver failure patients was conducted in PubMed/Medline (2002-dec 2012), according to pre-set selection criteria.
RESULTS: 20 out of 330 articles were retrieved, representing 43 patients with cirrhosis and/or liver failure who had an aspergillosis infection. Most Aspergillus (A.) infections were due to A. fumigatus and the lungs were the most frequent organ involved (42/43). 58% of the patients used steroids and mortality was 53.5%. The most frequent used antifungal was caspofungin.
DISCUSSION: Diagnosis of IA is difficult and there might be a delay in diagnosis since cirrhosis is not recognised as one of the classical risk factors. Mortality was 53.5%, but this is lower than in previous decades. Since voriconazole is hepatotoxic, treatment with caspofungin and/or amphotericin is preferable.
CONCLUSION: Early recognition of aspergillosis in a cirrhosis/liver failure patient is crucial and should prompt direct treatment.
PURPOSE: To evaluate the role of aspergillosis in cirrhosis.
METHODS: A literature search on aspergillosis in cirrhosis and liver failure patients was conducted in PubMed/Medline (2002-dec 2012), according to pre-set selection criteria.
RESULTS: 20 out of 330 articles were retrieved, representing 43 patients with cirrhosis and/or liver failure who had an aspergillosis infection. Most Aspergillus (A.) infections were due to A. fumigatus and the lungs were the most frequent organ involved (42/43). 58% of the patients used steroids and mortality was 53.5%. The most frequent used antifungal was caspofungin.
DISCUSSION: Diagnosis of IA is difficult and there might be a delay in diagnosis since cirrhosis is not recognised as one of the classical risk factors. Mortality was 53.5%, but this is lower than in previous decades. Since voriconazole is hepatotoxic, treatment with caspofungin and/or amphotericin is preferable.
CONCLUSION: Early recognition of aspergillosis in a cirrhosis/liver failure patient is crucial and should prompt direct treatment.