Department of Gastroenterology, Hangzhou Third People's Hospital, Hangzhou, China.
Medicine (Baltimore). 2024 Oct 25;103(43):e40103. doi: 10.1097/MD.0000000000040103.
Elderly patients with acute liver failure are highly susceptible to severe complications, such as invasive fungal infections, due to weakened immune systems and altered gut microbiota. A thorough understanding of liver failure and opportunistic infections is crucial for effective management.
An 84-year-old male with acute liver failure from hepatitis E experienced worsening jaundice despite standard treatments. He also developed respiratory symptoms, including blood-streaked sputum, raising concerns about a potential fungal infection.
The patient was diagnosed with acute liver failure secondary to hepatitis E and an invasive fungal infection caused by Aspergillus fumigatus. Initial treatments included artificial liver plasma exchange and antifungal prophylaxis. Further diagnostics, including bronchoscopy and next-generation sequencing of alveolar lavage fluid, confirmed the Aspergillus infection.
Elderly liver failure patients are particularly prone to opportunistic infections, underscoring the need for vigilant monitoring and early intervention. Despite aggressive treatments, including antifungal therapy and artificial liver support, prognosis remains poor, highlighting the importance of prompt diagnosis and comprehensive management to enhance patient outcomes.
老年急性肝衰竭患者由于免疫系统减弱和肠道微生物群改变，极易发生侵袭性真菌感染等严重并发症。深入了解肝衰竭和机会性感染对于有效管理至关重要。
一名 84 岁男性因戊型肝炎导致急性肝衰竭，尽管接受了标准治疗，但黄疸仍逐渐加重。他还出现了呼吸症状，包括带血丝的痰，这引发了对潜在真菌感染的担忧。
该患者被诊断为戊型肝炎引起的急性肝衰竭和烟曲霉引起的侵袭性真菌感染。初始治疗包括人工肝血浆置换和抗真菌预防。进一步的诊断，包括支气管镜检查和肺泡灌洗液的下一代测序，确认了曲霉感染。
老年肝衰竭患者特别容易发生机会性感染，这突显了需要进行警惕监测和早期干预。尽管进行了包括抗真菌治疗和人工肝支持在内的积极治疗，但预后仍然很差，这强调了及时诊断和综合管理的重要性，以提高患者的治疗效果。
