Invasive pulmonary mucormycosis and aspergillosis in a patient with decompensated hepatic cirrhosis

Persichino, Jon; Can, Argun; Van, Tam T.; Matthews, Michele; Filler, Scott G.

doi:10.1016/j.mmcr.2018.03.004

Cited by 7 publications

(6 citation statements)

References 15 publications

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“…In our experience, the number of cirrhotic patients admitted in ICU increases, in an order of 5–10% each year. Our findings concerning the incidence of aspergillosis colonisation are consistent with previously published data [12, 13, 23, 24]. Indeed, the rate of fungal colonisation can reach 25% in critically ill cirrhotic patients, with Aspergillosis up to 3% [25].…”

Section: Discussionsupporting

confidence: 92%

“…Increasing numbers of fungal infections are also being observed [6, 7]. Among these pathogens, Aspergillus species, especially in respiratory samples, have emerged as an important cause of life-threatening infections in cirrhotic patients [8–13]. In immunocompromised patients, neutropenia and/or undergoing hematopoietic stem cell or solid organ transplantation, invasive pulmonary aspergillosis (IPA) is a major cause of morbidity and mortality [14].…”

Section: Introductionmentioning

confidence: 99%

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Invasive pulmonary aspergillosis in cirrhotic patients: analysis of a 10-year clinical experience

Levesque

Aït-Ammar

Dudau

et al. 2019

Ann. Intensive Care

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Background Cirrhosis is not recognised as one of the main risk factors of invasive pulmonary aspergillosis (IPA), although its prevalence is increasing. The aim of our study was to identify factors for IPA in such patients with a positive Aspergillus sp. culture in respiratory samples and to evaluate its impact on outcome. Methods We conducted a monocentric retrospective study between January 2005 and December 2015. All cirrhotic patients hospitalised in our liver ICU with a positive Aspergillus sp. respiratory sample were included. These patients were case-matched with cirrhotic patients without positive Aspergillus respiratory sample. Finally, the patients were classified as having putative aspergillosis or colonisation according to the criteria described previously. Results In total, 986 cirrhotic patients were admitted to ICU during the study period. Among these, sixty patients had a positive Aspergillus sp. respiratory sample. Chronic obstructive pulmonary disease (COPD) comorbidity and organ supports were significantly associated with Aspergillus colonisation. Seventeen patients (28%) were diagnosed as proven or putative IPA and 43 were considered as colonised by Aspergillus sp. The median delay between ICU admission and an IPA diagnosis was 2 [2–24] days. Only COPD was predictive of the presence of IPA (OR 6.44; 95% CI 1.43–28.92; p = 0.0151) in patients with a positive Aspergillus sp. culture. The probability of in-hospital mortality was 71% in the IPA group versus 19% in the colonisation group ( p = 0.0001). Conclusion Patients with cirrhosis can be at risk of IPA, especially with COPD. Antifungal agents should be given as soon as possible mainly in cirrhotic patients with COPD.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Invasive pulmonary aspergillosis in cirrhotic patients: analysis of a 10-year clinical experience

Levesque

Aït-Ammar

Dudau

et al. 2019

Ann. Intensive Care

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“…Diabetes stands as the strongest risk factor with a previous review of 929 patients found that 36% of the patients were diabetic [1] . Other rare association is liver cirrhosis as we found only 24 previous cases in literature [2] .…”

Section: Discussionmentioning

confidence: 62%

“…Diabetes mellitus stands as the strongest risk factor giving that 36% of patients with invasive mucormycosis were diabetic in a previous review of 929 cases [1] . Association with liver cirrhosis is rare and previous literature reviews revealed only few cases [2] .…”

Section: Introductionmentioning

confidence: 99%

Invasive rhinocerebral mucormycosis in a patient with liver cirrhosis leading to fatal massive stroke

Sabobeh

Mushtaq

Elsotouhy

et al. 2018

Medical Mycology Case Reports

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Immunocompromised status is associated with invasive fungal infections including mucormycosis. These infections are challenging to treat and associated with high overall mortality.Here we report a fatal case of invasive mucormycosis in a cirrhotic, diabetic patient. Despite the swift diagnosis and management; the fungal invasion of the right internal carotid artery lead to massive ischemic stroke.Timely diagnosis and management is crucial for management but it seems not always enough and new approaches for treatment must be sought.

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“…Zebra ish larvae at 4dpf show distinct characteristics of swimming pattern with respective to light conditions (Persichino et al, 2018). Here, zebra ish with the aim of developing a liver toxicity model to replace higher vertebrates was investigated.…”

Section: The Effect Of Ism On Alcohol-induced Liver Damage Analysismentioning

confidence: 99%

Antimicrobial and hepatoprotective effect of ISM Drug in alcohol induced liver damage on Zebrafish larvae

Cynthia¹,

Averal²

2020

ijrps

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Liver cirrhosis occurs due to the extracellular matrix proteins accumulation which distorts the hepatic structure. The aim of our study is to investigate the antimicrobial and hepatoprotective effect of India Siddha Medicine(ISM) drug in alcohol-induced liver damage on zebrafish larvae. ISM drug, a hepatoprotective agent comprising of 15 herbs offers numerous formulations with advantages of hepatocellular rejuvenation has proven to be the most effective treatment to suppress liver damage. A series of analyses were carried out using alcohol-induced liver damage through herbal-based therapeutic drug and agar well diffusion method. For the hepatoprotective study, the zebrafish larvae were exposed to different concentrations of ethanol % (0.01, 0.05, 0.1, 0.5) and the treatment with 217.2 µg/ml of ISM drug has been evaluated. The outcome revealed the effect of ISM on alcohol-induced zebrafish larvae with a substantial increase in the percentage of viability. ISM drug showed antibacterial and antifungal activity in the diffusion method with a maximum zone of inhibition observed as 12 mm and 13.5 mm, respectively. Taken together, these results showed that the drug has hepatoprotective and antimicrobial activity which can be used for the treatment of liver cirrhosis.

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Invasive pulmonary mucormycosis and aspergillosis in a patient with decompensated hepatic cirrhosis

Cited by 7 publications

References 15 publications

Invasive pulmonary aspergillosis in cirrhotic patients: analysis of a 10-year clinical experience

Invasive pulmonary aspergillosis in cirrhotic patients: analysis of a 10-year clinical experience

Invasive rhinocerebral mucormycosis in a patient with liver cirrhosis leading to fatal massive stroke

Antimicrobial and hepatoprotective effect of ISM Drug in alcohol induced liver damage on Zebrafish larvae

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