Spontaneous fungal peritonitis: Epidemiology, current evidence and future prospective

World J Gastroenterol. 2016 Sep 14;22(34):7742-7. doi: 10.3748/wjg.v22.i34.7742.

Abstract

Spontaneous bacterial peritonitis is a complication of ascitic patients with end-stage liver disease (ESLD); spontaneous fungal peritonitis (SFP) is a complication of ESLD less known and described. ESLD is associated to immunodepression and the resulting increased susceptibility to infections. Recent perspectives of the management of the critically ill patient with ESLD do not specify the rate of isolation of fungi in critically ill patients, not even the antifungals used for the prophylaxis, neither optimal treatment. We reviewed, in order to focus the epidemiology, characteristics, and, considering the high mortality rate of SFP, the use of optimal empirical antifungal therapy the current literature.

Keywords: Cirrhosis; Critically ill patient; Fungal ascitis; Life-threatening infections; Nosocomial spontaneous peritonitis; Spontaneous fungal peritonitis.

Publication types

  • Review

MeSH terms

  • Antifungal Agents / therapeutic use
  • Ascites / microbiology
  • Ascitic Fluid / microbiology
  • Bacterial Infections / complications
  • Bacterial Infections / epidemiology*
  • Bacterial Infections / microbiology*
  • Bacterial Infections / therapy
  • Critical Illness
  • Cross Infection / complications
  • End Stage Liver Disease / complications
  • Humans
  • Liver Cirrhosis / complications
  • Mycoses / complications
  • Mycoses / epidemiology*
  • Mycoses / microbiology*
  • Mycoses / therapy
  • Peritonitis / complications
  • Peritonitis / epidemiology*
  • Peritonitis / microbiology*
  • Peritonitis / therapy
  • Risk Factors

Substances

  • Antifungal Agents