title: Acute febrile illness in cirrhosis - thinking beyond spontaneous bacterial peritonitis!
abstract: The aim of this study was to look at the aetiological factors presenting as acute febrile illness in cirrhotic patients. The study group included all cirrhotic patients admitted as inpatients between January and December 2011 with a history of fever of less than seven days duration. Detailed history, clinical examination and investigations, as required, were noted. The data collected were analysed. A total of 42 patients formed the study group. The male-to-female ratio was 9.5:1. The mean age at presentation was 45.09 years (24-77 years). The aetiological factors for fever were: spontaneous bacterial peritonitis (20), lower respiratory tract infection (8), urinary tract infection (6), lower limb cellulitis (4), acute cholecystitis (2) and malaria (2). The mean MELD (model for end-stage liver disease) score at presentation was 20.4. Three patients with spontaneous bacterial peritonitis (SBP) and a mean MELD score of 31 died during the hospital admission. Febrile illness in cirrhosis is attributable to multiple causes. Outcome is dependent on the severity of underlying liver disease.
authors.affiliation: Department of Gastroenterology, Choithram Hospital and Research Centre, Indore, India.
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Jain
authors.forename: Shohini
authors.initials: S
authors.lastname: Sircar
authors.forename: Mayank
authors.initials: M
authors.lastname: Jain
authors.forename: Sagar
authors.initials: S
authors.lastname: Adkar
authors.forename: Chandrashekhar
authors.initials: C
authors.lastname: Waghmare
authors.forename: Fatema
authors.initials: F
authors.lastname: Chahwala
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000465:Algorithms; D001424:Bacterial Infections / Q000150:complications / Q000175:diagnosis; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008288:Malaria / Q000150:complications; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D011379:Prognosis