Wednesday, November 14, 2012

 

Cirrhosis, cellulitis and cats: a 'purrfect' combination for life-threatening spontaneous bacterial peritonitis from Pasteurella multocida.


Cirrhosis, cellulitis and cats: a 'purrfect' combination for life-threatening spontaneous bacterial peritonitis from Pasteurella multocida.


Nov 2012

Hey P, Gow P, Torresi J, Testro A.

Source

Department of Gastroenterology, Austin Health, Heidelberg, Victoria, Australia.

Abstract


Pasteurella multocida is a Gram-negative coccobacillus that colonises the upper airways of many animals, in particular, dogs and cats. It acts as an opportunistic infection in humans following an animal bite or scratch and is associated with soft tissue infections, septicaemia and pneumonia, particularly in patients with a compromised immune response, such as patients with liver failure. Spontaneous bacterial peritonitis (SBP) is a serious complication of cirrhosis with a death rate of 10-15%. We report a case of a 47-year-old man with cirrhosis who presented with life-threatening P multocida SBP and bacteraemia secondary to a lick from a cat to a cellulitic leg wound. This case highlights the potential severity of an infection from domestic animals and an otherwise innocuous organism in an immunocompromised host.

PubMed

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# posted by Pat O'Connor @ 8:09 AM

Saturday, November 03, 2012

 

Acute febrile illness in cirrhosis - thinking beyond spontaneous bacterial peritonitis!


Acute febrile illness in cirrhosis - thinking beyond spontaneous bacterial peritonitis!


Nov 2012

Jain AK, Sircar S, Jain M, Adkar S, Waghmare C, Chahwala F.

Source

Department of Gastroenterology, Choithram Hospital and Research Centre, Indore, India.

Abstract


The aim of this study was to look at the aetiological factors presenting as acute febrile illness in cirrhotic patients. The study group included all cirrhotic patients admitted as inpatients between January and December 2011 with a history of fever of less than seven days duration. Detailed history, clinical examination and investigations, as required, were noted. The data collected were analysed. A total of 42 patients formed the study group. The male-to-female ratio was 9.5:1. The mean age at presentation was 45.09 years (24-77 years). The aetiological factors for fever were: spontaneous bacterial peritonitis (20), lower respiratory tract infection (8), urinary tract infection (6), lower limb cellulitis (4), acute cholecystitis (2) and malaria (2). The mean MELD (model for end-stage liver disease) score at presentation was 20.4. Three patients with spontaneous bacterial peritonitis (SBP) and a mean MELD score of 31 died during the hospital admission. Febrile illness in cirrhosis is attributable to multiple causes. Outcome is dependent on the severity of underlying liver disease.
PubMed

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# posted by Pat O'Connor @ 11:07 AM

Saturday, May 19, 2007

 

Bacterial Infection-Related Morbidity and Mortality in Cirrhosis.

Bacterial Infection-Related Morbidity and Mortality in Cirrhosis.

Am J Gastroenterol. 2007 May
Christou L,
Pappas G,
Falagas ME.
Division of Internal Medicine of the Medical School at the University of Ioannina, Ioannina, Greece.

OBJECTIVES:

Bacterial infections are acknowledged causes of morbidity and mortality in cirrhotic patients; yet, apart from spontaneous bacterial peritonitis, other infection issues have been understudied. We evaluated the existing medical data on infectious risks and related preventive and treatment data for cirrhotic patients.

METHODS:

Medical literature search through MEDLINE, using a variety of keywords focused on: (a) immunodeficiency parameters of cirrhosis and attempts at therapeutic reversal, (b) relative incidence of various focal infections and implications for prevention, and (c) specific pathogens posing a risk in cirrhosis and availability of preventive strategies.

RESULTS:

Immunodeficiency in cirrhosis is multifactorial and might not be reversed by isolated interventions. Epidemiologic data on the incidence of specific infections and risk factors are scarce, only Child-Pugh stage C being a common denominator. A variety of common, such as Staphylococcus aureus, Streptococcus pneumoniae, and Mycobacterium tuberculosis, as well as uncommon pathogens possess significant risks in cirrhosis. Certain aspects of these risks remain though unrecognized.

CONCLUSIONS:

To better understand the overall burden of bacterial infections on cirrhotic patients' survival, more data on preventive efficacy of pneumococcal vaccination, on the overall burden of tuberculosis, and the relative incidence of specific infections as endocarditis are warranted.

PMID: 17509025 [PubMed - as supplied by publisher]

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# posted by Pat O'Connor @ 8:11 PM

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