Invasive mycosis in medical intensive care unit patients with severe alcoholic hepatitis
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Invasive mycosis in medical intensive care unit patients with severe alcoholic hepatitis. / Lahmer, Tobias; Messer, Marlena; Schwerdtfeger, Christiane; Rasch, Sebastian; Lee, Marcel; Saugel, Bernd; Schmid, Roland M; Huber, Wolfgang.
in: MYCOPATHOLOGIA, Jahrgang 177, Nr. 3-4, 2014, S. 193-7.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Invasive mycosis in medical intensive care unit patients with severe alcoholic hepatitis
AU - Lahmer, Tobias
AU - Messer, Marlena
AU - Schwerdtfeger, Christiane
AU - Rasch, Sebastian
AU - Lee, Marcel
AU - Saugel, Bernd
AU - Schmid, Roland M
AU - Huber, Wolfgang
PY - 2014
Y1 - 2014
N2 - 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.
AB - 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.
U2 - 10.1007/s11046-014-9740-x
DO - 10.1007/s11046-014-9740-x
M3 - SCORING: Journal article
C2 - 24710759
VL - 177
SP - 193
EP - 197
JO - MYCOPATHOLOGIA
JF - MYCOPATHOLOGIA
SN - 0301-486X
IS - 3-4
ER -
