SPONTANEOUS BACTERIAL EMPYEMA IN CIRRHOTIC PATIENTS:CLINICAL FEATURES AND OUTCOMES | ||||
| Sohag Medical Journal | ||||
| Article 12, Volume 21, Issue 3, October 2017, Page 103-95 PDF (71.99 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/smj.2017.36491 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Ahmed Abd El Khalek1; Safaa Abd Allah 2; Khairy Hammam Morsy2
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| 1DDepartment of Tropical Medicine and Gastroenterology, Faculty, of Medicine University of Sohaggy | ||||
| 2Department of Tropical Medicine and Gastroenterology, Faculty, of Medicine University of Sohaggy | ||||
| Abstract | ||||
| AIM: The aim of this study is to determine the prevalence of spontaneous bacterial empyema among patients with liver cirrhosis and identify clinical features and outcomes of spontaneous bacterial empyema. patients AND METHODS : The study included 800 patients (males and females) presented with liver cirrhosis with and without ascites and pleural effusion . A total of 100 (57 males and 43 females) patients with liver cirrhosis and hepatic hydrothorax, (99 patients) with and (1 patients) without ascites were enrolled. Spontaneous bacterial empyema was diagnosed by a pleural fluid PMNL count >500 cells/mm3 without radiographic evidence of pneumonia or a contiguous infection process on chest radiography. RESULTS: the frequency of spontaneous bacterial empyema among cirrhotic patients with hepatic hydrothorax was 19% (19 out of 100 cirrhotic patients). CONCLUSION: SBEM was recognized in 19% of cirrhotic patients with ascites and hepatic hydrothorax. So, it is a frequent but underdiagnosed complication of hepatic hydrothorax and has a poor prognosis. | ||||
| Keywords | ||||
| Spontaneous bacterial empyema; Cirrhosis; hydrothorax | ||||
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| References | ||||
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1. Emam M, Ibrahim A, Galal S, et al. (2015): Study of Frequency ofSpontaneous Bacterial Empyema in Cirrhotic Patients With Hepatic Hydrothorax. Journal of Gastroenterology and Hepatology Research; 4(4): 1569-1572.
2. Makhlouf HA, Morsy KH,Makhlouf NA,Eldin EN,Khairy M (2013): Spontaneous bacterial empyema in patients with liver cirrhosis in Upper Egypt: prevalence and causative organisms. Hepatolint; 7: 274-279.
3. Garcia N Jr, Mihas AA. Hepatic hydrothorax: pathophysiology, diagnosis and management. J Clin Gastroenterol 2004;38:52–58.
4. Xiol X, Castellvi JM, Guardiola J, et al. Spontaneous bacterial empyema in cirrhotic patients: a prospective study. Hepatology
1996;23:719–723.
5. Gur C, Ilan Y, Shibolet O. Hepatic hydrothorax-pathophysiology, diagnosis and treatment: review of the literature. Liver Int
2004;24:281–284.
6. Roussos A, Philippou N, Mantzaris GJ, Gourgouliannis KI. Hepatic hydrothorax: pathophysiology, diagnosis and management. J Gastroenterol Hepatol 2007;22:1388–1393.
10. Xiol X, Castellote J, Baliellas C, et al. Spontaneous bacterial empyema in cirrhotic patients: analysis of eleven cases. Hepatology 1990;11:365–370.
11. Andreu M, Sola R, Sitges-Serra A, et al. Risk factors for spontaneous bacterial peritonitis in cirrhotic patients with ascites. Gastroenterology 1993;104:1133–1138.
12. Lazaridis KN, Frank JW, Krowka MJ, Kamath PS. Hepatic hydrothorax: pathogenesis, diagnosis, and management. Am J Med 1999;107:262–267.
13. Xiol X, Guardiola J. Hepatic hydrothorax. Curr Opin Pulm Med 1998;4:239–242.
14. Kinasewitz GT, Keddissi JI. Hepatic hydrothorax. Curr Opin Pulm Med 2003;9:261–265.
15. Chen T-A, Lo G-H, Lai K-H. Risk factors for spontaneous bacterial empyema in cirrhotic patients with hydrothorax. J Chin Med Assoc 2003;66:579–585.
7. Cardenas A, Kelleher T, Chopra S. Review article: hepatic hydrothorax. Aliment Pharmacol Ther 2004;20:271–279.
8. Chen C-H, Shih C-M, Chou J-W, et al. Outcome predictors of cirrhotic patients with spontaneous bacterial empyema. Liver Int 2011;31:417–424.
9. Allam NAH. Spontaneous bacterial empyema in liver cirrhosis: an underdiagnosed pleural complication. Saudi J Gastroenterol
2008;14:43–45.
16. Flaum MA. Spontaneous bacterial empyema in cirrhosis. Gastroenterology 1976;70:416–417.
17. Garcia Tsao G. Spontaneous bacterial peritonitis. Gastroenterol Clin North Am 1992;21:257–275.
18. Wyke RJ. Bacterial infections complicating liver disease. Baillieres Clin Gastroenterol 1989;3:187–210.
19. Sese E, Xiol X, Castellote J, Rodriguez-Farinas E, Tremosa G. Low complement levels and opsonic activity in hepatic hydrothorax: its relationship with spontaneous bacterial empyema. J Clin Gastroenterol 2003;36:75–77.
20. Felisart J, Rimola A, Arroyo V. Cefotaxime is more effective than is ampicillin-tobramycin in cirrhotics with severe infections. Hepatology 1985;5:457–462.
21. Runyon BA, Greenblatt M, Ming HC (1986) Hepatic hydrothorax treated for bacterial peritonitis. Dig Dis Sci 1991;36:1782–1786.
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