[Clinical profile and prognosis of bacteremia in patients with cirrhosis based on the Child-Pugh classification]
R Monte Secades1, E Casariego Vales, A Mateos Colino
1Servicio de Medicina Interna, Complexo Hospitalario Xeral-Calde, Lugo.
Abstract:
The characteristics of 70 cases of bacteremia in cirrhotic patients were studied according to the Child-Pugh classification as severity marker of liver involvement. Factors influencing on prognosis were determined. For a comparative analysis, 1,006 cases of bacteremia in non-cirrhotic patients were included. Sixteen patients corresponded to group A, 23 to group B and 31 to group C in the Child-Pugh classification. Patients in group A had a predominance of extra-enteric microorganisms, mainly Staphylococcus aureus (37.5%; p = 0.02), well-defined source (urinary tract, respiratory tract, skin) and good prognosis (mortality rate 6.2%). In contrast, patients in group C had a high recovery rate of Escherichia coli (41.9%) and pneumococcus (19.3%), undetermined source (51.6%; p = 0.05), ascites (83.9%), with or without concomitant peritonitis (41.1%; p = 0.03) and poor prognosis (mortality rate 48.3%; p = 0.008). The characteristics of patients in group B were similar to those of patients in group C but prognosis was as in patients in group A. The immediate mortality rate in the studied patients was 26%. The parameter which best predicted survival in the multivariate analysis was the Child-Pugh classification.
Related Concept Videos
Diseases of the Liver and Gallbladder
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not related to...
Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Pleural Effusion II: Symptoms and Management
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
Cirrhosis I: Introduction
Cirrhosis II: Pathophysiology
