Tiseo Giusy, Fais Roberta, Forniti Arianna, Melandro Fabio, Tavanti Arianna, Ghelardi Emilia, De Simone Paolo, Falcone Marco, Lupetti Antonella
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
Infez Med. 2021 Sep 10;29(3):464-468. doi: 10.53854/liim-2903-18. eCollection 2021.
Acute-on-chronic liver failure (ACLF) is often associated with a dismal outcome. Infections might preclude access to liver transplantation (LT) for these patients, further reducing their chance of survival. We report the case of a patient with ACLF who died before LT for biofilm-producing fungemia. The patient early started antifungal therapy with anidulafungin, but was not susceptible to echinocandins, delaying the start of active antifungal therapy. Although rare, invasive infections by spp. are associated with high mortality rates due to low antimicrobial susceptibility and production of biofilms on indwelling devices. Early diagnosis and treatment are crucial to reduce mortality and enhance patient survival.
慢加急性肝衰竭（ACLF）往往预后不佳。感染可能使这些患者无法接受肝移植（LT），进一步降低其生存几率。我们报告一例ACLF患者，因产生物膜的真菌血症在等待肝移植期间死亡。该患者早期开始使用阿尼芬净进行抗真菌治疗，但对棘白菌素不敏感，从而延误了有效的抗真菌治疗的开始。尽管罕见，但某些菌种引起的侵袭性感染由于抗菌药物敏感性低以及在留置装置上形成生物膜，与高死亡率相关。早期诊断和治疗对于降低死亡率和提高患者生存率至关重要。
