Clinical significance of untreated Candida species isolated from ascites in cirrhotic patients.
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.
Choi
Sang-Ho
SH
Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Republic of Korea.
Soo Kim
Yang
Y
Chung
Jin-Won
JW
Choo
Eun Ju
EJ
Kwak
Yee Gyung
YG
Lee
Yung Sang
YS
Kim
Mi-Na
MN
Woo
Jun Hee
JH
Ryu
Jiso
J
Kim
Nam Joong
NJ
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