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  • Title: [Retrospective and comparative study of pneumococcal bacteremia in patients with chronic hepatopathy].
    Author: Ramos Rincón JM, Cuenca Estrella M, Fernández Guerrero ML.
    Journal: An Med Interna; 1996 Jul; 13(7):313-6. PubMed ID: 8962974.
    Abstract:
    BACKGROUND: The chronic hepatopathy predispose to severe infections due to Streptococcus pneumoniae, including bacteremia. METHODS: We have reviewed the clinic characteristics and outcome of 34 patients without HIV infection and compared with 140 HIV-negative patients with pneumococcal bacteremia. RESULTS: From 34 patients with chronic liver diseases, 27 were male (79%) and 7 female (21%), aged from 33 to 83 years. In 16 cases the origin of hepatopathy were alcoholic. The majority of the patients had fever (85%). From 29 isolations of S. pneumoniae in which a sensibility study was available, 5 (17%) were resistant to penicillin. Among 27 (79%) cases of chronic hepatopathy, the bacteremia was associated with pneumonia; 5 (18%) cases had roentgenographic evidence of multiple-lobe involvement, and 6 (18%) had peritonitis. The independent factors associated with pneumococcal bacteremia in chronic hepatopathy patients were elevated concentrations of amino-transferases (p < 0.001), alcoholism (p < 0.001) and bacteremic peritonitis (p = 0.007). The overall case of fatality and bacteremia-related mortality rate were higher among patients with chronic hepatopathy than control group, without statistic signification (38% vs 25%; and 29% vs 24% of control group, respectively). The presence of septic shock was poor prognosis (mortality rate: 83% [10/12]; p < 0.001). The multilobar involvement was associated with high mortality rate (60%; p = 0.1). CONCLUSIONS: Pneumococcal bactermia in patients with chronic hepatopathy have a high mortality rate; however clinical outcome is similar to patients without chronic hepatopathy.
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