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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Liver abscess can be caused by bacterial, parasitic, or fungal infection. Amebic abscesses are more common, but pyogenic abscesses account for three quarters of hepatic abscess in developed countries. Most common pathogens of the pyogenic liver abscess are Escherichia coli, Klebsiella pneumoniae, Bacteroides, Enterococci, Streptococci, and Staphylococci. However, liver abscess caused by Salmonella species has rarely been reported. We experienced a case of Salmonella liver abscess which improved after antibiotic therapy and percutaneous drainage. The patient was 52 years-old man who had an episode of intermittent fever, chills and epigastric pain for 2 weeks. He was diagnosed as liver cirrhosis eight years ago and diabetes three years ago. Salmonella group D, non-typhi was cultured from blood and pus from the liver respectively at the same time. With percutaneous drainage and susceptible antibiotic therapy, liver abscess decreased in size with improvements in fever and abdominal pain.
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PMID:[A case of Salmonella liver abscess]. 1663 85

Torsade de pointes (TdP) is a potentially fatal arrhythmia that might be associated with systemic antifungal agent (SAFAs) administration. The objective of this study was to investigate all published reports on TdP induced by SAFAs in order to characterise this association. Each original report was analysed for the presence of risk factors for TdP: female gender, structural heart disease, electrolyte imbalance, concomitant use of a QT interval prolonging agent which SAFA inhibits its liver metabolism, liver cirrhosis, renal failure and more. Naranjo probability scale for adverse drug reactions was applied for every full report. Twenty-one reports on 28 patients were analysed. All patients survived. Most patients (25/28; 89.2%) used one or more agents that might have prolonged the QT interval and their liver metabolism might have been inhibited by SAFA. Female gender was the second most common risk factor for TdP (20/28; 71.4%). All patients, including female patients, had one or more risk factors for TdP prior to SAFA administration. According to Narajno probability scale, there was no definite association between TdP and SAFA in any report. SAFA alone might seldom trigger TdP. We wish to raise the level of awareness of risk factors for TdP prior to SAFA administration and for concomitant use of other dysrhythmogenic agents in particular.
Mycoses 2006 Nov
PMID:Torsade de pointes induced by systemic antifungal agents: lessons from a retrospective analysis of published case reports. 1702 62

Invasive aspergillosis is a frequently insidious syndrome that carries a poor prognosis even when promptly and appropriately treated. Those patients that are identified as possessing risk factors for invasive aspergillosis are more likely to receive early therapy. Patients with profound immunosuppression, such as those with hematologic malignancy, iatrogenic immunosuppression for solid organ transplant, and advanced AIDS, are clearly at risk for invasive aspergillosis. Recently, invasive aspergillosis has been reported in patients with subtle immune dysfunction such as those with critical illness and advanced cirrhosis. However, patients with early cirrhosis also possess risk for invasive mycoses. We report a case of non-decompensated cirrhosis as the predisposition to invasive aspergillosis and review the immune dysfunction of cirrhosis that creates this risk.
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PMID:Non-decompensated cirrhosis as a risk factor for invasive aspergillosis: a case report and review of the immune dysfunction of cirrhosis. 1803 Jan 92

Renal infarction is an uncommon finding at autopsy most often related to occlusive thromboembolism or to trauma. A 42-year-old woman is reported who presented with persistent right flank pain after an alleged assault with injury to the area 3 weeks previously. Renal infarction necessitated a right nephrectomy that was followed by multiorgan failure and death. Given the possible link between the assault and the renal pathology, a homicide investigation was initiated. Although renal infarction had been confirmed by hospital pathologists, microscopy with special staining of both kidneys and the heart after autopsy revealed multifocal areas of angioinvasion by fungi having morphologic characteristics of mucormycosis. The only other finding of significance was alcohol-related micronodular cirrhosis of the liver. Renal infarction had therefore been caused by an angioinvasive fungal infection predisposed to by immunocompromise associated with alcoholism and not by trauma-induced arterial dissection. This case demonstrates that careful histological assessment of tissues from medicolegal autopsies may occasionally identify unexpected and rare disorders that have been confused with the sequelae of inflicted injury.
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PMID:Disseminated fungal infection with renal infarction simulating homicide. 2093 25

The prevalence of invasive mycoses is increasing, especially among patients who are immunocompromised or hospitalized with serious underlying diseases. Such infections are associated with a high morbidity and significant mortality, requiring early diagnosis and appropriate treatment but also an optimal prophylaxis in patients with high risk factors. We report a case of triple fungal infection including an invasive pulmonary aspergillosis by Aspergillus fumigatus, a candidemia by Candida albicans and a Pneumocystis pneumonia. The overall clinical picture of this patient was liver cirrhosis with medical history of immunosuppressive treatment for Crohn disease and a non-hodgkin lymphoma. There was no antifungal prophylaxis for this patient. Under treatment, the issue was unfavourable with multivisceral failure.
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PMID:[Triple fungal infection in a patient with liver cirrhosis]. 2229 41

We present a rare case of combined fungal infection in a critically ill 47 year-old patient with chronic hepatitis C at the stage of liver cirrhosis. The patient was admitted for signs of decompensated cirrhosis caused by hepatitis C and increased alcohol consumption. After 2 week hospital stay, his condition was complicated by a pulmonary infiltrate and rapid deterioration followed. Despite intensive care, the patient died. Autopsy findings showed invasive pulmonary aspergillosis. The aim of this case report is to point to a broad differential diagnosis of jaundice and pulmonary infiltrates, thus stressing the value of interdisciplinary cooperation and the need to consider the possibility of invasive fungal infections when caring for liver cirrhosis patients. In addition, several risk factors contributing to the development of fungal diseases in these patients are discussed in the article.
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PMID:[Invasive pulmonary aspergillosis and esophageal candidiasis in a patient with decompensated liver cirrhosis due to chronic hepatitis C and alcohol]. 2248 74

Mucormycosis is an invasive fungal infection associated with a high mortality rate, especially in immunocompromised hosts. Mucormycosis rarely occurs in cirrhotic patients. Here, we report a case of mucormycosis with underlying liver cirrhosis and diabetes mellitus. The patient suffered from maxillary sinusitis and osteomyelitis, and the infection was successfully treated with antifungal agents, surgical debridement, and hyperbaric oxygen therapy. The antifungal treatments used were liposomal amphotericin B, itraconazole, and posaconazole. Although our patient had liver cirrhosis (Child-Pugh classification B), no hepatic decompensation was developed during the treatment course of posaconazole. This is the first report of the safe and effective use of posaconazole for the treatment of mucormycosis in a cirrhotic patient.
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PMID:A mucormycosis case in a cirrhotic patient successfully treated with posaconazole and review of published literature. 2274 22

Post-transplant malignancy is the major cause of later death of recipients after liver transplantation. Tumor recurrence after liver transplantation for patients with hepatocellular carcinoma in the end stage of cirrhosis has been frequently encountered. However, de novo hepatocellular carcinoma originating from the liver allograft has only rarely been reported. Here we reported a case of de novo hepatocellular carcinoma developed 2 years after living donor liver transplantation for hepatitis B-related liver cirrhosis with viral YMDD mutation. To the best of our knowledge, this is the first report of de novo hepatocellular carcinoma in a liver graft with recurrent hepatitis B virus infection after liver transplantation for hepatitis B-related liver cirrhosis with YMDD mutation. Moreover, the de novo cancer first presented as a lung mass with minimal liver involvement and was obscured by a pulmonary fungal infection.
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PMID:A case report of de novo hepatocellular carcinoma after living donor liver transplantation. 2391 66

Invasive mycoses are a rising problem, not only in traditional categories of patients like hematologic or neutropenic ones, but also in elderly non-neutropenic patients admitted to internal medicine wards. Patients being admitted to medical wards are usually older, have multiple comorbidities, e.g., liver cirrhosis or chronic obstructive respiratory disease, may be malnourished or receive peripheral or total parenteral nutrition, and frequently are undergoing chronic corticosteroid therapy, chemotherapy for cancer or monoclonal antibodies for autoimmune diseases. Such risk factors may be contemporarily present in a single patient increasing the risk for the development of invasive mycoses. Diagnosis of candidemia and invasive aspergillosis is particularly difficult in patients hospitalized on medical wards, since symptoms and signs have low specificity, and most diagnostic tests have been only validated in neutropenic hematologic patients, but not in those without neutropenia. Both candidemia and invasive aspergillosis carry significant morbidity and mortality. The aim of this paper is to provide a simple guide to physicians for a prompt identification and treatment of patients with possible or suspected invasive mycoses.
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PMID:Identification and management of invasive mycoses in internal medicine: a road-map for physicians. 2487 36

Gastrointestinal (GI) mucormycosis is a rare and life-threatening invasive fungal infection. GI mucormycosis occur in all parts of the alimentary tract, with the stomach being the most common site. Diabetes mellitus and other types of conditions associated with immunodeficiency, including hematologic malignancies, solid organ transplantation and glucocorticoid therapy, are risk factors for GI mucormycosis. There are few studies reporting cases of gastric mucormycosis in patients with liver cirrhosis, and even fewer reporting the successful treatment of invasive gastric mucormycosis in a patient with liver cirrhosis. This study presents a case of invasive gastric mucormycosis in a patient with liver cirrhosis, which was treated successfully by prompt diagnosis, metabolic support, surgical debridement of involved tissues and antifungal therapy.
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PMID:Successful treatment of invasive gastric mucormycosis in a patient with alcoholic liver cirrhosis: A case report. 2500 90


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