Unit of Internal Medicine and Hepatology (UIMH), Department of Medicine (DIMED), University and Hospital of Padova, via Giustiniani 2, Padova 35100, Italy.
Unit of Internal Medicine and Hepatology (UIMH), Department of Medicine (DIMED), University and Hospital of Padova, via Giustiniani 2, Padova 35100, Italy.
Clin Liver Dis. 2024 Aug;28(3):525-539. doi: 10.1016/j.cld.2024.03.007. Epub 2024 Apr 27.
Patients with cirrhosis and clinically significant portal hypertension are at high risk of developing bacterial infections (BIs) that are the most common trigger of acute decompensation and acute-on-chronic liver failure. Furthermore, after decompensation, the risk of developing BIs further increases in an ominous vicious circle. BIs may be subtle, and they should be ruled out in all patients at admission and in case of deterioration. Timely administration of adequate empirical antibiotics is the cornerstone of treatment. Herein, we reviewed current evidences about pathogenesis, clinical implications and management of BIs in patients with cirrhosis and portal hypertension.
肝硬化和临床上显著的门静脉高压症患者发生细菌感染（BI）的风险很高，BI 是急性失代偿和慢加急性肝衰竭的最常见诱因。此外，在失代偿后，BI 的发生风险在一个不祥的恶性循环中进一步增加。BI 可能是隐匿的，因此应在所有入院患者和病情恶化时排除 BI。及时给予足够的经验性抗生素治疗是治疗的基石。本文综述了目前关于肝硬化和门静脉高压症患者 BI 的发病机制、临床意义和管理的证据。
