title: Sepsis in cirrhosis: emerging concepts in pathogenesis, diagnosis and management.
abstract: Infections and sepsis are more common in cirrhotic than in the general population and constitute the commonest cause of sudden worsening and death. The diagnosis of systemic inflammatory syndrome and sepsis are challenging in cirrhotics due to an underlying a state of hyperdynamic circulation. Further, poor nutritional and bone marrow reserves lead to modest host immune response, the so called immunoparalysis state and the outcome of antibiotic therapy is suboptimal. In this review, a comprehensive description of current and emerging concepts in the pathogenesis and diagnosis of sepsis with importance to current and novel biomarkers for diagnosis of sepsis in cirrhosis is presented. Furthermore, novel treatment options and preventive strategies are discussed to improve the overall survival.
authors.affiliation: Department of Hepatology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, Delhi, 110070, India.
authors.forename: Cyriac Abby
authors.initials: CA
authors.lastname: Philips
authors.affiliation: Department of Hepatology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, Delhi, 110070, India. shivsarin@gmail.com.
authors.forename: Shiv Kumar
authors.initials: SK
authors.lastname: Sarin
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019468:Disease Management; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000276:immunology; D012307:Risk Factors; D016019:Survival Analysis; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; Cirrhosis; Cytokines; Immunoparalysis; Infection; Inflammatory response; Portal hypertension; Sepsis; Septic shock