title: Fungal infections in liver transplant patients admitted to the intensive care unit.
abstract: BACKGROUND
  Fungal infections have a significant impact on patient survival after liver transplantation, mostly caused by Candida and Aspergillus. The clinical manifestations vary, and range from colonization, active local infection, to severe invasive form. A high degree of suspicion is required for the early diagnosis and, accordingly, the optimal management of these infections. This study aimed to evaluate fungal infection in the Intensive care Unit (ICU) in admitted liver transplant patients, focussing of etiologic agent, clinical/laboratory presentation (including mortality), and risk factors.
  
  
  METHODS
  This retrospective study included living related liver transplanted patients admitted to the ICU. Clinical data was collected, thorough clinical evaluation was done, and laboratory tests were performed. Microbiological examination detecting the presence of fungus in various samples, using cultures and serology, and imaging investigations were carried out in all patients.
  
  
  RESULTS
  This study included 23 cases of ICU-admitted liver transplant patients who were diagnosed with fungal infection. Candida was the most common fungal infection and occurred at a mean of 2 months after transplantation; while Aspergillus was less common and occurred later with worse laboratory findings. Invasive fungal infection constituted 43% of the diagnosed cases. Difference in mortality between Aspergillus and Candida was insignificant, as was difference between patients with and without fungal infection.
  
  
  CONCLUSIONS
  Fungal infection among LT patients was common, including the invasive forms.
authors.affiliation: Department of Endemic Medicine and Hepatogastroenterology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Raghda
authors.initials: R
authors.lastname: Marzaban
authors.affiliation: Department of Anaesthesia and Intensive Care, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Maged
authors.initials: M
authors.lastname: Salah
authors.affiliation: Department of Anaesthesia and Intensive Care, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Mukhtar
authors.affiliation: Department of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Reham A
authors.initials: RA
authors.lastname: Dwedar
authors.affiliation: Department of Medical Microbiology and Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Walaa
authors.initials: W
authors.lastname: Abdel-Latif
authors.affiliation: Department of Intensive Care, Wady El-Nile hospital, Cairo, Egypt.
authors.forename: Ihab
authors.initials: I
authors.lastname: Mahmoud
mesh_terms: D000328:Adult; D001228:Aspergillosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D002177:Candidiasis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors