Clinical Characteristics Of Liver Failure Complicated By Fungus Infection

Liver failure can develop as acute liver failure (ALF), sub-ALF, acute-on chronic liver failure (ACLF), or a chronic liver failure. Patients with liver failure differ from etiology, age, complication, therapy, etc. However they are common in a mass hepatocellular necrosis and immune system impaired, which can easily be infected by bacteria and fungus. Of fungus infection, candida and aspergillus are more common in patients with liver failure. Patients infected with candida and aspergillus have different clinical characteristics, which is to be discussed in this paper.Objective The aim of this study is to analysis the clinical characteristics of patients infected with fungus. Methods we did a retrospective study with 681 patients form January 1985 to September 2009 of 302 military hospital enrolled. Results Of 361 patients,361 were candida infected and 83 were aspergillus infected. Patients were predominant with mail, acute on chronic liver failure and chronic liver failure. Virus hepatitis especially hepatitis B was the main etiology. Previous bacteria infection could be found in most patients, with a feature of multi-infection-site and multi-strain, but mainly in peritoneal cavity and gram-negative bacillus. Patients infected with bacteria were often treated by combination of different antibiotics with a long course. Moreover, glucocorticoid was often used in the patients. At these conditions, fungus infections were mainly nosocomial infection. Pars oralis pharynges was the most common infection site of candida, then were lungs and digestive tract. Fungus culture results showed that the most common strain was candida albicans, next were candida tropicalis and candida glabrata. However, the most common infection site of aspergillus was lungs, and the rate of Aspergillus fumigatus infection was much more than rates of other aspergilli infection such that Aspergillus niger and aspergillus flavus. Patients with fungus infections presented symptoms like fever, cough and expectoration, etc. Pseudomembrane could appear when patients with pars oralis pharynges candida infection. Medical treatments for patient with fungus infection was fluconazole, itraconazole, voriconazole, amphotericin or nystatin, etc. Conclusion Patients' condition with liver failure was dangerous. Complications happened frequently. And therapeutic measures didn't have the intended effect. Patients complicate with candida infection and aspergillus infection are related to a poor response to therapeutic measures. High fatality rate happened, higher to aspergillus.