European Journal of Cardiovascular Medicine

Liver cirrhosis is a disease causing significant morbidity and mortality. Mortality in liver cirrhosis is mainly due to complications which are seen in decompensated stage. Incidence and prevalence of fungal infections are increasing especially as opportunistic infections in those with decompensated liver failure as a result of a pre-existing immunocompromised state. There is a low index of suspicion for infections in such patients due to lack of classical clinical features, hence it is being missed or diagnosed late. Hence, we performed this study to analyse the spectrum of infections in liver cirrhosis patients as well as the risk factors associated with it. Materials and Methods: This is a prospective observational study performed in a tertiary care centre. It included 125 known patients of liver cirrhosis with a clinical evidence of infection. In a semi-structured pro forma, presenting complaints, history of comorbid illnesses, past hospitalizations and medication intake were noted. Statistical analysis was done with SPSS v15. Results: We observed that 46 patients(36.8%) had bacterial growth, 4 patients (3.2%) had fungal growth and 12 patients(9.6%) had mixed growth (bacterial and fungal). Most common sources of infection was urinary tract (25.8%) and multisystem infection (25.8%) followed by respiratory tract infection-24.1%. The most common bacterial organisms isolated were Klebseilla (25%), and most common fungal was Candida albicans-8 (42%). 18 patients expired during hospital stay; decompensated liver disease with hepatic encephalopathy was the most common cause (33.3%). Conclusion: In patients diagnosed with CLD having underlying infections, factors like hypoalbuminemia and diabetes can further impair the immune status, worsening the decompensation. In this study we also identified certain specific risk factors like diabetes, hypoalbuminemia and other immunocompromised state. Hence, we recommend treating patients with culture-guided antibiotics/antifungals to improve outcomes.