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Invasive mycosis in medical intensive care unit patients with severe alcoholic hepatitis

Tobias Lahmer1, Marlena Messer, Christiane Schwerdtfeger

  • 1II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, Munich, Germany, Tobias.Lahmer@lrz.tu-muenchen.de.

Mycopathologia
|April 9, 2014
PubMed
Abstract

Insights

Severe alcoholic hepatitis (AH) patients treated with corticosteroids face a high risk of invasive fungal infections, particularly invasive aspergillosis (IA), leading to a near 100% mortality rate.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Severe alcoholic hepatitis (AH) carries a high short-term mortality risk, often due to infections.
  • The incidence and impact of invasive fungal infections in AH patients receiving corticosteroids remain largely unknown.

Purpose of the Study:

  • To investigate the incidence of invasive mycosis in patients with severe alcoholic hepatitis treated with corticosteroids.
  • To determine the impact of invasive fungal infections on mortality in this patient population.

Main Methods:

  • Retrospective analysis of 12 intensive care unit (ICU) patients with histologically proven AH.
  • Patients were treated with corticosteroids, with some also receiving pentoxifylline.

Main Results:

  • Five patients developed invasive aspergillosis (IA), three had candidemia, and two had Candida colonization.
  • IA was associated with 100% mortality, while candidemia had a 70% mortality rate.
  • Only two patients showed no evidence of fungal infection.

Conclusions:

  • Patients with severe AH exhibit increased susceptibility to invasive mycosis.
  • Invasive fungal infections in AH patients are associated with high mortality, necessitating high clinical suspicion and prophylactic strategies.

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