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[Retrospective and comparative study of pneumococcal bacteremia in patients with chronic hepatopathy]


An Med Interna. 1996 Jul;13(7):313-6. Unique Identifier : AIDSLINE

BACKGROUND: The chronic hepatopathy predispose to severe infections due to Streptococcus pneumoniae, including bacteremia. METHODS: We have reviewed the clinic characteristics and outcome of 34 patients without HIV infection and compared with 140 HIV-negative patients with pneumococcal bacteremia. RESULTS: From 34 patients with chronic liver diseases, 27 were male (79%) and 7 female (21%), aged from 33 to 83 years. In 16 cases the origin of hepatopathy were alcoholic. The majority of the patients had fever (85%). From 29 isolations of S. pneumoniae in which a sensibility study was available, 5 (17%) were resistant to penicillin. Among 27 (79%) cases of chronic hepatopathy, the bacteremia was associated with pneumonia; 5 (18%) cases had roentgenographic evidence of multiple-lobe involvement, and 6 (18%) had peritonitis. The independent factors associated with pneumococcal bacteremia in chronic hepatopathy patients were elevated concentrations of amino-transferases (p < 0.001), alcoholism (p < 0.001) and bacteremic peritonitis (p = 0.007). The overall case of fatality and bacteremia-related mortality rate were higher among patients with chronic hepatopathy than control group, without statistic signification (38% vs 25%; and 29% vs 24% of control group, respectively). The presence of septic shock was poor prognosis (mortality rate: 83% [10/12]; p < 0.001). The multilobar involvement was associated with high mortality rate (60%; p = 0.1). CONCLUSIONS: Pneumococcal bactermia in patients with chronic hepatopathy have a high mortality rate; however clinical outcome is similar to patients without chronic hepatopathy.

Adult Aged Aged, 80 and over Bacteremia/DRUG THERAPY/*EPIDEMIOLOGY/MICROBIOLOGY Chronic Disease Comorbidity Comparative Study Drug Resistance, Microbial English Abstract Female Human Immunocompromised Host Liver Diseases/*EPIDEMIOLOGY Liver Diseases, Alcoholic/EPIDEMIOLOGY Male Middle Age Peritonitis/DRUG THERAPY/EPIDEMIOLOGY/MICROBIOLOGY Pneumococcal Infections/DRUG THERAPY/*EPIDEMIOLOGY/MICROBIOLOGY Pneumonia, Lobar/DRUG THERAPY/EPIDEMIOLOGY/MICROBIOLOGY Prognosis Retrospective Studies Streptococcus pneumoniae/DRUG EFFECTS/ISOLATION & PURIF JOURNAL ARTICLE REVIEW REVIEW, MULTICASE


Information in this article was accurate in February 28, 1997. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.