Cirrhosis, gastrointestinal bleed, and cryptococcal peritonitis.
Disseminated Cryptococcus neoformans infection rarely causes peritonitis in non–HIV-infected patients but does affect cirrhotic patients. Diagnostic challenges delay treatment, and mortality is high. We performed a literature search of proven cryptococcal peritonitis cases in HIV-negative adults wit...
| Publicado en: | Baylor University Medical Center Proceedings Vol. 33; no. 2; pp. 195 - 199 |
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| Autores principales: | , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Taylor & Francis Ltd
Apr-Jun2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=142554451&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 142554451 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 08998280 1XEP jtl: Baylor University Medical Center Proceedings issn: 08998280 maglogo: N pubinfo: dt: Apr-Jun2020 vid: 33 iid: 2 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 142554451 142554451 145568676 142554451 10.1080/08998280.2020.1723361 142554451 ppf: 195 ppct: 4 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Cirrhosis, gastrointestinal bleed, and cryptococcal peritonitis. aug: au: Barnett, Amy E. Brust, Karen B. affil: Department of Internal Medicine, Baylor Scott & White Medical Center – Temple, Temple, Texas sug: subj: Cryptococcus Peritonitis Liver Cirrhosis Gastrointestinal Hemorrhage Amphotericin B Therapeutic Use Human Peritonitis Risk Factors Peritonitis Symptoms Peritonitis Diagnosis Mortality Systematic Review Male Female Adult Middle Age Aged Descriptive Statistics PubMed Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Disseminated Cryptococcus neoformans infection rarely causes peritonitis in non–HIV-infected patients but does affect cirrhotic patients. Diagnostic challenges delay treatment, and mortality is high. We performed a literature search of proven cryptococcal peritonitis cases in HIV-negative adults with underlying cirrhosis, included our own case, and collected demographic, infection risk factor, diagnostic, treatment, and outcomes data. We identified 16 articles and 21 cases. Most patients were men. Alcohol abuse was the leading cause of underlying cirrhosis (n = 10, 48%). Eight (38%) patients experienced an upper gastrointestinal bleed (UGIB) within a month before peritonitis presentation. Peritoneal fluid analysis was abnormal and lymphocytic predominant. Half the patients were fungemic. When performed, peritoneal fluid cryptococcal antigen (CrAg) test results were positive. Amphotericin B was the primary treatment. Mortality was high at 76%. In conclusion, C. neoformans is an opportunistic pathogen that causes peritonitis in non-HIV, cirrhotic patients. People with recent UGIB seem to be at risk. Cryptococcus species infection should be suspected in patients with clinical signs and symptoms of spontaneous bacterial peritonitis whose lymphocytic-predominant peritoneal fluid and cultures are negative for bacterial growth. Peritoneal CrAg testing expedites diagnosis because growth on fungal media is slow. Mortality remains high, despite standard therapy with amphotericin B. pubtype: Academic Journal doctype: research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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