Abstract
BackgroundOpportunistic invasive fungal infections are increasingly frequent in intensive care patients. Their clinical spectrum goes beyond the patients with malignancies, and for example invasive pulmonary aspergillosis has recently been described in critically ill patients without such condition. Liver failure has been suspected to be a risk factor for aspergillosis.Case presentationWe describe three cases of adult respiratory distress syndrome with sepsis, shock and multiple organ failure in patients with severe liver failure among whom two had positive Aspergillus antigenemia and one had a positive Aspergillus serology. In all cases bronchoalveolar lavage fluid was positive for Aspergillus fumigatus. Outcome was fatal in all cases despite treatment with voriconazole and agressive symptomatic treatment.ConclusionInvasive aspergillosis should be among rapidly raised hypothesis in cirrhotic patients developing acute respiratory symptoms and alveolar opacities.
Highlights
Opportunistic invasive fungal infections are increasingly frequent in intensive care patients
Invasive pulmonary aspergillosis has recently been described in critically ill patients without malignancy [2,3,4], and Aspergilluss is increasingly considered as an emerging pathogen in non-hematological patients
This condition has be considered as a possible risk factor for invasive pulmonary aspergillosis, all the more so that acute liver failure is known to promote fungal infection
Summary
Opportunistic invasive fungal infections are increasingly frequent in intensive care patients. Among the non-hematological patients diagnosed with invasive pulmonary aspergillosis in the critical care setting were patients with Child C liver cirrhosis [3]. This condition has be considered as a possible risk factor for invasive pulmonary aspergillosis, all the more so that acute liver failure is known to promote fungal infection (page number not for citation purposes)
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