Infections in Patients With End-stage Liver Disease.

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Infections in Patients With

End-stage Liver Disease.

Liver,

Pancreas and Biliary Tract

Journal

of Clinical Gastroenterology. April 2007.

Cheruvattath, Rekha MD; Balan, Vijayan MD

Abstract:

Infections in patients with end-stage liver disease (ESLD) are an important

cause of morbidity and mortality in these patients. Abnormalities

in their natural defense mechanisms, alterations in the enteric flora and the

growing utilization of invasive procedures increase the risk of infections in

these patients. Common bacterial infections in ESLD

patients include spontaneous bacterial peritonitis, urinary tract infections,

community-acquired pneumonia, dermatologic infections, and bacteremia. Viral infections such as influenza can have a devastating

course in ESLD patients. Hepatitis B and C are now

among the most common causes of ESLD. They also

present an important therapeutic challenge. As

patients with human immunodeficiency virus are surviving longer, ESLD due to

hepatitis C is now emerging as a leading cause of morbidity in these patients. Prompt detection of infections, use of appropriate

antibiotics for treatment and prophylactic measures such as vaccinations can

help improve survival in these patients.

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