title: Clinical significance of untreated Candida species isolated from ascites in cirrhotic patients.
abstract: The clinical significance of Candida species isolated from cirrhotic ascites is still unknown. We reviewed the clinical and laboratory features of all cirrhotic patients whose ascites samples were positive for Candida species. A total of 21 cirrhotic patients was identified. Patients were regarded as having peritonitis if they had 1 or more clinical symptom(s) or sign(s) in the absence of any other possible explanation. 10 patients (47.6%) were classified into the spontaneous Candida peritonitis (SCP) group, and the remaining 11 patients (52.4%) were classified into asymptomatic candidascites. Mortalities were higher in the SCP group at discharge (50.0% vs 27.3%), 6-month (90% vs 45.5%) and 1-y (100% vs 54.5%) (p=0.007). Receiver-operating characteristic curve analysis revealed that the cut-off value of ascitic fluid polymorphonuclear cell count of 315/mm(3) (0.315 x 10(9)/l) had the highest diagnostic accuracy with both sensitivity and specificity of 1.0. In conclusion, Candida species are associated with a grave outcome when manifested with peritonitis.
authors.affiliation: Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Republic of Korea.
authors.forename: Sang-Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Yang
authors.initials: Y
authors.lastname: Soo Kim
authors.forename: Jin-Won
authors.initials: JW
authors.lastname: Chung
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Choo
authors.forename: Yee Gyung
authors.initials: YG
authors.lastname: Kwak
authors.forename: Yung Sang
authors.initials: YS
authors.lastname: Lee
authors.forename: Mi-Na
authors.initials: MN
authors.lastname: Kim
authors.forename: Jun Hee
authors.initials: JH
authors.lastname: Woo
authors.forename: Jiso
authors.initials: J
authors.lastname: Ryu
authors.forename: Nam Joong
authors.initials: NJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001202:Ascitic Fluid / Q000382:microbiology*; D002175:Candida / Q000145:classification*; D002177:Candidiasis / Q000175:diagnosis* / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007723:Korea / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000453:epidemiology / Q000382:microbiology*; D011336:Probability; D011379:Prognosis; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D016019:Survival Analysis