Spontaneous fungal peritonitis: Epidemiology, current evidence and future prospective

Area of Science:

• Hepatology
• Infectious Diseases
• Critical Care Medicine

Background:

• End-stage liver disease (ESLD) is linked to immune suppression, increasing infection risk.
• Spontaneous bacterial peritonitis is a known complication; spontaneous fungal peritonitis (SFP) is less recognized.
• Current critical care guidelines for ESLD patients lack specific recommendations for fungal infections.

Purpose of the Study:

• To review the current literature on spontaneous fungal peritonitis (SFP).
• To focus on the epidemiology and characteristics of SFP in end-stage liver disease (ESLD) patients.
• To evaluate optimal empirical antifungal therapy for SFP, given its high mortality.

Main Methods:

• Literature review of current scientific articles.
• Focus on studies detailing fungal peritonitis in critically ill patients with ESLD.
• Analysis of reported fungal isolation rates, antifungal prophylaxis, and treatment strategies.

Main Results:

• Spontaneous fungal peritonitis (SFP) is an underdiagnosed complication in end-stage liver disease (ESLD).
• Data on fungal isolation rates and antifungal use in critically ill ESLD patients are scarce.
• High mortality associated with SFP necessitates further investigation into optimal management.

Conclusions:

• Spontaneous fungal peritonitis (SFP) is a significant, yet underappreciated, complication in end-stage liver disease (ESLD).
• There is a critical need for defined guidelines regarding antifungal prophylaxis and treatment in these patients.
• Further research is essential to establish optimal empirical antifungal therapy and improve outcomes for SFP.