Invasive Pulmonary Aspergillosis in Patients with End-Stage Liver Disease: A Case Series

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Varun Arumugham, Jayavignesh Jayachandran, Pravin Selvam Selvaraj, Kirubhakaran Kanakaraju, Ranga Bashyam S R


Objective: This case series aims to investigate the clinical presentation, diagnostic challenges, and outcomes of invasive pulmonary aspergillosis in patients with decompensated cirrhosis.

Methods: We reviewed the medical records of five patients diagnosed with decompensated cirrhosis who developed Invasive pulmonary aspergillosis. Detailed clinical information, including demographic data, liver disease etiology, symptoms, diagnostic methods, treatment approaches, and outcomes, was collected and analyzed.

Results: The patients, aged between 45 and 67 years, presented with a range of symptoms, including fever, cough, dyspnea, and pleuritic chest pain. All patients had advanced liver disease with complications such as ascites and hepatic encephalopathy. Diagnostic imaging often showed nodules and halo signs, and diagnosis was confirmed through serum galactomannan assays and bronchoalveolar lavage (BAL) fluid analysis. Voriconazole was the primary antifungal treatment, but the overall prognosis was poor, with three out of five patients succumbing to the infection despite aggressive therapy.

Conclusion: Invasive pulmonary aspergillosis in patients with decompensated cirrhosis presents significant diagnostic and therapeutic challenges, often leading to high mortality rates. Early recognition, accurate diagnosis, and appropriate management are critical to improving outcomes in this vulnerable population.

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