Infections in severe alcoholic hepatitis

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Infections in severe alcoholic hepatitis (EN)

Gustot, Thierry; C.U.B. Erasme Université Libre de Bruxelles
Karakike, Eleni; C.H.U. Brugmann
Moreno, Christophe; C.U.B. Erasme Université Libre de Bruxelles

Severe alcoholic hepatitis (sAH), defined by a modified discriminant function ≥32, is the most severe form of alcohol-induced liver disease and is associated with a 1-month mortality rate of around 30%. Corticosteroid treatment remains the only therapeutic option that improves shortterm survival. Infectious complications, occurring in approximately 50% of patients, are the main causes of death, even in patients who benefit from corticosteroids. Liver failure, recent alcohol consumption and immunosuppressive drugs contribute to this infectious risk. Although infection is a well-described feature of cirrhosis, little is known about the characteristics of infections in sAH. Infection is mainly of bacterial origin and frequently aff ects the respiratory tract. Pathogens classically observed in cirrhosis, such as gram-negative bacilli, are frequently involved, but opportunistic pathogens, such as fungi (Aspergillus fumigatus, Pneumocystis jirovecii) or viruses (Cytomegalovirus, Herpes simplex) may appear, mainly related to corticosteroid treatment. A high level of suspicion with systematic screening and prompt, adequate treatment are warranted to improve outcomes in these patients. Prophylactic strategies in this high-risk population should be assessed in well-designed trials.Keywords Alcoholic hepatitis, infection, corticosteroids, aspergillosisAnn Gastroenterol 2017; 30 (2): 152-160 (EN)

Ελληνική Γαστροεντερολογική Εταιρία (EL)
Hellenic Gastroenterologiki Company (EN)

2017-02-23


Annals of Gastroenterology (EN)

Annals of Gastroenterology; Volume 30, No 2 (2017); 152 (EN)



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