Presentation and Outcomes of End Stage Liver Disease Patients Presenting with Septic Shock to the Emergency Department

Patients with end stage liver disease (ESLD) are particularly vulnerable to sepsis. ESLD patients are often excluded from controlled sepsis trials and more data are needed to guide the management of this population.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research

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Authors: George E, Rajalakshmi A Abstract Melioidosis is an infectious disease caused by gram negative bacterium Burkholderia pseudomallei. It is a soil and water pathogen and transmitted to humans through inoculation or inhalation. This disease is considered endemic in India and largely remains under reported. The most common presentation is pneumonia and bacteraemia, which can present acutely and as septic shock. Chronic presentation include-abscess, septic arthritis, osteomyelitis. The major risk factors are diabetes, liver disease, renal disease, chronic lung disease. In this article 18 cases have been reviewed...
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
Authors: Barcelos STA, Dall'Oglio VM, de Araújo A, Cerski CTS, Álvares-da-Silva MR Abstract Hepatic sinusoidal obstruction syndrome (HSOS) is a hepatic vascular disease histologically characterized by edema, necrosis, detachment of endothelial cells in small sinusoidal hepatic and interlobular veins and intrahepatic congestion, which leads to portal hypertension and liver dysfunction. In the Western world, most HSOS cases are associated with myeloablative pretreatment in a hematopoietic stem cell transplantation setting. Here we report a case of a 54 years old female patient, otherwise healthy, with n...
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
Conclusion: Addition of LDT to tenofovir is safe and may be renoprotective in spontaneous reactivation of hepatitis B. Combination therapy improves survival in ACLF-B despite comparable HBV DNA suppression to tenofovir monotherapy.
Source: The Saudi Journal of Gastroenterology - Category: Gastroenterology Authors: Source Type: research
Bacterial infections are more frequent and severe in patients with advanced liver disease and, therefore, in liver transplant candidates. The increased risk of infection in these patients parallels the severity of the immune dysfunction associated with cirrhosis, featured by systemic inflammation and progressive immunodeficiency. Other factors contribute to this risk, such as genetic polymorphisms, proton-pump inhibitor overuse, the numerous invasive procedures and hospitalizations these patients go through, or the immunosuppressive effects of malnutrition or alcohol abuse. Bacterial infections have a great impact on disea...
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news
CONCLUSION: Our results demonstrated that the total cost of LTx is closely related to liver disease severity scores and the development of complications.RESUMO CONTEXTO: O transplante hep ático (TxH) é o principal e definitivo tratamento de casos agudos ou crônicos de doenças hepáticas avançadas ou terminais. Poucos estudos têm avaliado o custo real do TxH categorizado por setores hospitalares. OBJETIVO: Avaliar o custo do TxH categorizado por especialidade da unidade em um centro de referência na região sul do Brasil. MÉTODOS: Analisamos retrospectivamente...
Source: Arquivos de Gastroenterologia - Category: Gastroenterology Source Type: research
CONCLUSION: N-SBP was significantly associated with recent antibiotic use, longer hospitalisation, more resistant organisms and poorer survival among patients with SBP. N-SBP and MELD score predict higher mortality in SBP. Judicious use of antibiotics may reduce N-SBP and improve survival among cirrhotic patients. PMID: 31363784 [PubMed - as supplied by publisher]
Source: Singapore Medical Journal - Category: General Medicine Authors: Tags: Singapore Med J Source Type: research
Conclusions: Cellulitis in compensated cirrhosis is different from that of decompensated patients regarding microorganisms, pathogenesis, and prognosis. Cellulitis has a poor prognosis, with mortality rates approaching 100% in decompensated patients with gram-negative cellulitis. Stratifying patients according to severity of cirrhosis is important to identify the proper empirical antibiotic and to decide the proper means of care. PMID: 31177653 [PubMed - as supplied by publisher]
Source: Clinical and molecular hepatology - Category: Gastroenterology Tags: Clin Mol Hepatol Source Type: research
ConclusionPneumococcal peritonitis has a rare occurrence and represents a clinical challenge because of its subtle and non-specific clinical findings. The interest in our case lays in the relatively rare diagnosis of primary peritonitis mimicking acute appendicitis.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
ConclusionsOur study suggests that severity of baseline condition and receiving inappropriate experience antibiotic therapy are major risk factors for higher mortality in patients with CRAB infections. These findings may help clinicians to take appropriate preventive measures and decrease mortality in such patients.
Source: American Journal of Infection Control - Category: Infectious Diseases Source Type: research
ConclusionsThese findings question a “one-size-fits-all” approach to fluid administration and performance measures for patients with sepsis.
Source: Journal of Critical Care - Category: Gastroenterology Source Type: research
More News: Emergency Medicine | Liver | Liver Disease | Septic Shock | Urology & Nephrology