Walsh T J, Hamilton S R
Arch Intern Med. 1983 Jun;143(6):1189-91.
Disseminated aspergillosis is not generally known as a complication of hepatic failure. Three patients with subacute hepatic necrosis died of clinically unrecognized disseminated aspergillosis. All of the patients had pulmonary aspergillosis and Aspergillus infections of the CNS. Focal neurologic deficits were clinically misconstrued as intracerebral hemorrhages caused by the coagulopathy of liver failure. Signs of invasive pulmonary aspergillosis were ascribed to refractory bacterial pneumonia. Each patient had a hospital course of longer than three weeks and each received treatment with corticosteroids and intravenous antibiotics. Invasive aspergillosis should be considered as a cause of refractory pneumonia and of new focal neurologic deficits in patients with hepatic failure.
播散性曲霉病通常不被认为是肝衰竭的并发症。三名亚急性肝坏死患者死于临床未识别的播散性曲霉病。所有患者均患有肺曲霉病和中枢神经系统曲霉感染。局灶性神经功能缺损在临床上被误诊为肝衰竭凝血障碍导致的脑出血。侵袭性肺曲霉病的体征被归因于难治性细菌性肺炎。每位患者的住院病程均超过三周，且均接受了皮质类固醇和静脉内抗生素治疗。对于肝衰竭患者，侵袭性曲霉病应被视为难治性肺炎和新出现的局灶性神经功能缺损的病因。
