BMC Gastroenterology (Jan 2007)

Invasive pulmonary aspergillosis in patients with decompensated cirrhosis: case series

  • Poynard Thierry,
  • Derenne Jean-Philippe,
  • Datry Annick,
  • Duguet Alexandre,
  • Thabut Dominique,
  • Barrault Camille,
  • Massard Julien,
  • Cracco Christophe,
  • Prodanovic Hélène,
  • Similowski Thomas

DOI
https://doi.org/10.1186/1471-230X-7-2
Journal volume & issue
Vol. 7, no. 1
p. 2

Abstract

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Abstract 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 agressive symptomatic treatment. Conclusion Invasive aspergillosis should be among rapidly raised hypothesis in cirrhotic patients developing acute respiratory symptoms and alveolar opacities.