Limits...
Spontaneous fungal peritonitis: Epidemiology, current evidence and future prospective

View Article: PubMed Central - PubMed

ABSTRACT

Spontaneous bacterial peritonitis is a complication of ascitic patients with end-stage liver disease (ESLD); spontaneous fungal peritonitis (SFP) is a complication of ESLD less known and described. ESLD is associated to immunodepression and the resulting increased susceptibility to infections. Recent perspectives of the management of the critically ill patient with ESLD do not specify the rate of isolation of fungi in critically ill patients, not even the antifungals used for the prophylaxis, neither optimal treatment. We reviewed, in order to focus the epidemiology, characteristics, and, considering the high mortality rate of SFP, the use of optimal empirical antifungal therapy the current literature.

No MeSH data available.


Related in: MedlinePlus

Spontaneous fungal peritonitis management algorithm. Risk factors for fungal diseases[32]: Surgery, total parenteral nutrition, fungal colonisation, renal replacement therapy, infection and/or sepsis, mechanical ventilation, diabetes, and APACHE II or III score; Add-on: consider adding empiric antifungal therapy. APACHE: Acute physiology and chronic health evaluation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC5016373&req=5

Figure 1: Spontaneous fungal peritonitis management algorithm. Risk factors for fungal diseases[32]: Surgery, total parenteral nutrition, fungal colonisation, renal replacement therapy, infection and/or sepsis, mechanical ventilation, diabetes, and APACHE II or III score; Add-on: consider adding empiric antifungal therapy. APACHE: Acute physiology and chronic health evaluation.

Mentions: Micafungin in a different setting of patients with ESLD (liver transplant patients with a MELD score ≥ 20) showed non inferiority to standard antifungal prophylaxis, although renal function showed a better performance in micafungin group[31]. In conclusion an algorithm should be proposed for the treatment of patients with suspected SFP (Figure 1).


Spontaneous fungal peritonitis: Epidemiology, current evidence and future prospective
Spontaneous fungal peritonitis management algorithm. Risk factors for fungal diseases[32]: Surgery, total parenteral nutrition, fungal colonisation, renal replacement therapy, infection and/or sepsis, mechanical ventilation, diabetes, and APACHE II or III score; Add-on: consider adding empiric antifungal therapy. APACHE: Acute physiology and chronic health evaluation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5016373&req=5

Figure 1: Spontaneous fungal peritonitis management algorithm. Risk factors for fungal diseases[32]: Surgery, total parenteral nutrition, fungal colonisation, renal replacement therapy, infection and/or sepsis, mechanical ventilation, diabetes, and APACHE II or III score; Add-on: consider adding empiric antifungal therapy. APACHE: Acute physiology and chronic health evaluation.
Mentions: Micafungin in a different setting of patients with ESLD (liver transplant patients with a MELD score ≥ 20) showed non inferiority to standard antifungal prophylaxis, although renal function showed a better performance in micafungin group[31]. In conclusion an algorithm should be proposed for the treatment of patients with suspected SFP (Figure 1).

View Article: PubMed Central - PubMed

ABSTRACT

Spontaneous bacterial peritonitis is a complication of ascitic patients with end-stage liver disease (ESLD); spontaneous fungal peritonitis (SFP) is a complication of ESLD less known and described. ESLD is associated to immunodepression and the resulting increased susceptibility to infections. Recent perspectives of the management of the critically ill patient with ESLD do not specify the rate of isolation of fungi in critically ill patients, not even the antifungals used for the prophylaxis, neither optimal treatment. We reviewed, in order to focus the epidemiology, characteristics, and, considering the high mortality rate of SFP, the use of optimal empirical antifungal therapy the current literature.

No MeSH data available.


Related in: MedlinePlus