Sepsis Research Today is a free monthly online journal that collates and summarizes the latest research about Sepsis, including details on septicemia, diagnosis, symptoms, treatment.

Invasive pulmonary aspergillosis in patients with decompensated cirrhosis: case series.

Prodanovic H, Cracco C, Massard J, Barrault C, Thabut D, Duguet A, Datry A, Derenne JP, Poynard T, Similowski T

Assistance Publique--Hôpitaux de Paris, Service de Pneumologie et Réanimation, Groupe Hospitalier Pitié-Salpêtrière, Paris, France. helene.prodanovic@psl.ap-hop-paris.fr <helene.prodanovic@psl.ap-hop-paris.fr>

BACKGROUND: Opportunistic invasive fungal infections are increasingly frequent in intensive care patients. Their clinical spectrum goes beyond the patients with malignancies, and for example invasive pulmonary aspergillosis has recently been described in critically ill patients without such condition. Liver failure has been suspected to be a risk factor for aspergillosis. CASE PRESENTATION: We describe three cases of adult respiratory distress syndrome with sepsis, shock and multiple organ failure in patients with severe liver failure among whom two had positive Aspergillus antigenemia and one had a positive Aspergillus serology. In all cases bronchoalveolar lavage fluid was positive for Aspergillus fumigatus. Outcome was fatal in all cases despite treatment with voriconazole and aggressive symptomatic treatment. CONCLUSION: Invasive aspergillosis should be among rapidly raised hypothesis in cirrhotic patients developing acute respiratory symptoms and alveolar opacities.

Published 13 February 2007 in BMC Gastroenterol, 7: 2.
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