dc.contributor.author
Lahmer, Tobias
dc.contributor.author
Brandl, Andreas
dc.contributor.author
Rasch, Sebastian
dc.contributor.author
Schmid, Roland M.
dc.contributor.author
Huber, Wolfgang
dc.date.accessioned
2018-06-08T04:19:21Z
dc.date.available
2016-08-23T12:03:09.883Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/17051
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-21231
dc.description.abstract
Introduction Spontaneous peritonitis, especially spontaneous fungal
peritonitis (SFP), is an important and potentially fatal complication in
patients with endstage liver disaese. We evaluated potential risk factors,
microbiological findings, and outcome of patients with SFP compared to
spontaneous bacterial peritonitis (SBP) in critically ill patients. Methods
Retrospective analyses of critically ill patients with suspected spontaneous
peritonitis. Results Out of 205 patients, 20 (10%) had SFP, 28 (14%) had SBP,
48 (24%) had peritonitis without microbiological findings (SP) and 109 (52%)
had no-peritonitis (NP). APACHE II and SOFA score were significantly higher in
patients with SFP (26; 22–28; p<0.004 and 16; 14–18; p<0.002), SBP (26; 22–28;
p<0.004 and 16; 14–18; p<0.002) and SP (24; 18–30; p<0.045 and 14; 10–18;
p<0.044) as compared to NP (22; 16–24 and 12; 10–14). CHILD Pugh
classification was mainly CHILD C and MELD Score was in patients with SFP (34;
18–40; p<0.001), SBP (32;12–40 p<0.002) and SP (29; 14–40 p<0.003)
significantly higher as compared to NP (25;8–40). Nosocomial peritonitis could
be significantly more often found in patients with SFP (65%; p<0.023) and SBP
(62%, p<0.030) as compared to SP (51 p = 0.243) and NP (45%). Antibiotic
pretreatment last 3 month prior peritonitis was significantly more often in
patients with SFP (85%; p<0.002), SBP (71%, p<0.033), and SP (56; p<0.040) as
compared to NP (33%). Candida albicans (60%; 12/20) was the most common
isolated fungus, followed by Candida glabrata (13%) and Candida krusei (13%).
Mortality rate was significantly higher in patients with SFP (90%, p<0.001),
followed by SBP (75%; p<0.001) and SP (69%; p<0.001) as compared to NP (45%).
Conclusion SFP is not a rare complication in end stage liver disease which is
associated with increased mortality. Physicians should be aware of SFP in
patients with CHILD C liver cirrhosis, elevated MELD score, antibiotic
pretreatment and nosocomial peritonitis.
en
dc.rights.uri
http://creativecommons.org/licenses/by/4.0/
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften
dc.title
Fungal Peritonitis
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation
PLoS ONE. - 11 (2016), 7, Artikel Nr. e0158389
dc.title.subtitle
Underestimated Disease in Critically Ill Patients with Liver Cirrhosis and
Spontaneous Peritonitis
dcterms.bibliographicCitation.doi
10.1371/journal.pone.0158389
dcterms.bibliographicCitation.url
http://dx.doi.org/10.1371/journal.pone.0158389
refubium.affiliation
Charité - Universitätsmedizin Berlin
de
refubium.mycore.fudocsId
FUDOCS_document_000000025102
refubium.note.author
Der Artikel wurde in einer Open-Access-Zeitschrift publiziert.
refubium.resourceType.isindependentpub
no
refubium.mycore.derivateId
FUDOCS_derivate_000000006863
dcterms.accessRights.openaire
open access