A clinical analysis on invasive pulmonary aspergillosis in patients with hepatic failure

Abstract

Objective To explore the risk factors,clinical characteristics,and proguosis ofinvasive pulmonary aspergillosis ( IPA ) in patients with hepatic failure.Methods The clinical data of 15 patients with hepatic failure complicated with IPA were analyzed retrospectively.Results All the patients had an underlying disorder that was chronic hepatitis B,but had no granulocytopenia or agranulocytosis.The MELD score was ( 37.13 ± 11.03 )46.7％ ( 7/15 ) of the patients had history of hormone uses ; 60％ ( 9/15 ) had history of broad-spectrum antibiotic uses ( single or mulitple ) 60％ ( 9/15 )of patients received previous blood purification.33.3％ ( 5/15 )had a reduction in CD4+ T cells or ratio imbalance.Clinical manifestations lacked of obvious specificity.Roentgenographic examination of the lungs showed changes in all the patients; GM test was positive in 73.3％ ( 11/15 )of the patients.20％ ( 3/15 )of the patients improved after treatment; 80％ ( 12/15 ) did not repond to therapies; and 40％ ( 6/15 ) were dead within 7 days after diagnosis.Conclusions Patients with hepatic failure have multiple risk factors of invasive pulmonary aspergillosis.IPA is one of the reasons for deterioration in patients with hepatic failure.Early CT examination combined with GM tests can increase the early diagnostic rate.Early effective antifungal therapy can improve the prognosis of the disease. Key words: Hepatic failure; Invasive pulmonary aspergillosis; Risk factors; Prognosis