Spontaneous fungal peritonitis is not a rare infection in cirrhotic patients with ascites: A cross-sectional Study

Abdelrahman, Mona M.; Farag, Radwa M.; Orabi, Osama A.; Shafik, Noha S.; Maher, Amira; Makbol, Reem M.

doi:10.21608/mid.2023.252202.1683

Spontaneous fungal peritonitis is not a rare infection in cirrhotic patients with ascites: A cross-sectional Study

Document Type : Original Article

Authors

¹ Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Sohag University, Sohag, Egypt

² Department of Clinical and chemical pathology, Faculty of Medicine, Sohag University, Sohag, Eygpt

³ Department of Internal medicine, Faculty of Medicine, Sohag University, Sohag, Egypt

⁴ Department of Medical Microbiology and Immunology, faculty of medicine, Sohag university, Egypt

10.21608/mid.2023.252202.1683

Abstract

Background: In individuals with terminal-stage liver disease, spontaneous peritonitis, particularly spontaneous fungal peritonitis, is a serious fatal condition. We assessed different risk variables, microbiological results, and patient outcomes in SFP patients compared to patients with spontaneous bacterial peritonitis. Objective: We aimed to evaluate the frequency and risk factors for the development of SFP in cirrhotic patients with ascites. Patients and methods: We conducted a cross-sectional study on 154 cirrhotic patients with ascites (102 males and 52 females) who were admitted to the Tropical Medicine and Gastroenterology Departments in our Hospital. The samples were sent to the clinical and chemical pathology laboratory at Sohag university hospital. Detailed history, clinical examination, ascitic fluid analysis, laboratory investigations, abdominal ultrasonography, and bacterial and fungal cultures from ascitic fluid were performed. Results: The patients were categorized into 3 groups according to the ascitic fluid analysis and the bacterial and fungal culture. The first group included 69 patients (44.5%) who were diagnosed with SBP. The second group included 15 patients (9.7%) who were diagnosed with SFP. The third group included 71 patients (45.8%) who were diagnosed with liver cirrhosis without ascitic fluid infection. As regard the bacterial and fungal culture of ascitic fluid, Escherichia coli was the most reported bacterial infection (32.7%) followed by Klebsiella pneumonia (22.4%), while Candida ciferrii was the most reported fungal infection (10.2%) followed by Candida albicans (8.2%). Conclusions: SFP is not a rare complication of liver cirrhosis with ascites. It should be considered mainly in patients with high Model of End-stage Liver Disease and Child-Turcotte- Pugh scores.

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