Intestinal candidiasis. A clinical report and comments about this opportunistic pathology

Clinical analysis of 42 patients with chronic severe hepatitis complicated with intestinal fungal infection

AIM: To investigate the clinical features, risk factors and preventive measures for chronic severe hepatitis complicated with intestinal fungal infection.

METHODS: Ninety-eight patients with chronic severe hepatitis treated from April 2010 to July 2014 at the First Hospital of Fujian Medical University were retrospectively studied, including 42 cases with fungal infection and 56 cases without. The constituent ratios of the species of fungi causing intestinal infections were analyzed. Univariate and multivariate analyses were used to identify the risk factors for intestinal fungal infection in patients with chronic severe hepatitis.

RESULTS: Intestinal fungal infection in patients with chronic severe hepatitis was mainly caused by Candida albicans (43.75%). Univariate analysis indicated that duration of antibiotic use, spontaneous bacterial peritonitis, portal hypertension, length of hospital stay > 30 d, hypoalbuminemia and white blood cell count (WBC) < 4.0 × 10⁹/L were risk factors for intestinal fungal infection in patients with chronic severe hepatitis (P < 0.05). Multivariate logistic regression analysis showed that duration of antibiotic use (OR = 3.410), leucopenia (OR = 3.018), portal hypertension (OR = 2.357) and hypoalbuminemia (OR = 2.161) were independent risk factors (P < 0.05). The mortality rate was significantly higher in infected patients than in non-infected patients [33.33% (14/42) vs 16.07% (9/56), P = 0.023].

CONCLUSION: Intestinal fungal infection in patients with chronic severe hepatitis is mainly caused by Candida albicans, and is associated with a high mortality rate. Duration of antibiotic use, leucopenia, portal hypertension and hypoalbuminemia are independent risk factors for intestinal fungal infection in patients with chronic severe hepatitis.