Infections in cirrhotic patients

Document Type : Review articles

Authors

1 tropical Medicine dept., Faculty of Medicine, Mansoura Univ., Egypt

2 Tropical Medicine dept., Mansoura Univ., Egypt.

Abstract

Cirrhosis is considered to be the final stage of various liver injuries.
Cirrhotic patients are more vulnerable to an increased incidence of
infections than normal population. Various theories had been
postulated to explain the higher frequency of infections among
cirrhotic patients including alterations in the enteric flora,
dysfunction of the intestinal barrier and impairment of the host
defense mechanisms. In particular, bacterial infections could
be a precipitating factor for deterioration of the liver condition
and occurrence of number of life threatening complications such
as acute on top of chronic liver failure (ACLF), acute kidney
injury, hepatic encephalopathy, coagulation defect and variceal
bleeding. Among the infections described in cirrhotic patients,
spontaneous bacterial peritonitis, pneumonia, urinary tract infection,
soft tissue infection, and bacteraemia were found to be the
most repeatedly encountered. Assuming that, infections in cirrhotic
patients are considered as alarming signs, prompt and definitive
management strategies should be undertaken. This manuscript
focuses on bacterial infections in cirrhotic patients as regard
pathophysiology, types, consequences and management.

Keywords