Bacterial infections associated with hepatic encephalopathy: Prevalence and outcome

Strauss, Edna; Ribeiro, Maria Estela Bellini

doi:10.1016/s1665-2681(19)32157-x

Cited by 40 publications

(27 citation statements)

References 23 publications

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“…Cirrhosis was due to hepatitis C in 51% of cases and alcohol abuse in 19%. Child class was A in 30%, B in 39%, and C in 31% of patients and the median MELD score at admission was 13.5 (range: [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. The main reasons of hospital admission were: ascites in 37 patients (25%), elective procedures in 33 (22%), suspected infection in 21 (14%), overt HE in 20 (13%), gastrointestinal bleeding in 12 (8%), renal failure in 5 (3%), and other reasons in the remaining 22 patients (15%).…”

Section: Resultsmentioning

confidence: 99%

“…Hepatic encephalopathy (HE) is among the complications triggered by a bacterial infection. In fact, a concomitant infection is frequent in cirrhotic patients with overt HE [7] being a common precipitating factor for this neurocognitive alteration [8]. A causal relationship between infection, systemic inflammation, and HE has been suggested by several authors [9,10].…”

Section: Introductionmentioning

confidence: 99%

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Increased risk of cognitive impairment in cirrhotic patients with bacterial infections

Merli

Lucidi

Pentassuglio

et al. 2013

Journal of Hepatology

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Increased risk of cognitive impairment in cirrhotic patients with bacterial infections

Merli

Lucidi

Pentassuglio

et al. 2013

Journal of Hepatology

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“…Bacterial infection, especially with intestinal-type bacterial flora, is a common complication in patients with cirrhosis [1][2][3][4]. Spontaneous bacterial peritonitis (SBP), urinary tract infection, pneumonia, spontaneous bacterial empyema and bacteraemia are the most frequent infective complications in this group.…”

mentioning

confidence: 99%

The intestinal flora and bacterial infection in cirrhosis

Riordan

Williams

2006

Journal of Hepatology

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“…Die Funktionsstörungen aufgrund der Astrozytenschwellung führen in der Summe zu bisher noch nicht in allen Einzelheiten bekannten Störungen in der glia-neuronalen Kommunikation, die letztlich in Neuroinhibition und neurologischer Dysfunktion und damit dem klinischen Bild der HE resultieren (Abbildung 1). Die Tatsache tigend [29]. Prinzipiell ist dabei die Organlokalisation der Infektion nebensächlich.…”

Section: Funktionsstörung Der Astrozyten Im Rahmen Der Hepatischen Enunclassified

“…Letztlich kann aber auch jede andere Infektion außer-halb des Gastrointestinaltrakts, wie z.B. eine Pneumonie oder Pyelonephritis, über die oben beschriebenen Mechanismen zur Entwicklung einer HE führen [29]. [9].…”

Section: Funktionsstörung Der Astrozyten Im Rahmen Der Hepatischen Enunclassified

Hepatische Enzephalopathie

Hilgard

Gerken

2004

Med Klin

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Hepatic encephalopathy (HE) may develop within the course of acute or chronic liver failure and is characterized by a complex of psychomotor symptoms. In addition, HE can be induced by portocaval shunting even in the absence of any apparent liver disease. HE is caused by substances, which are either reabsorbed from the gut or are a product of the body metabolism. Normally, these substances are effectively eliminated during their first passage through the liver. However, a decreasing number of functional hepatocytes or the presence of portocaval collaterals in liver disease may significantly impair hepatic detoxification. Ammonia seems to take a central position in the pathogenesis of HE, although the exact cerebral effects of this metabolite are still not known in detail. The actual pathogenetic hypotheses are subject of this review. Depending on the underlying liver disease, HE is divided into an acute and a chronic form. Chronic HE may be present as a persistent or an episodic form, the latter being usually induced by defined precipitating factors, such as diet failures, infection and gastrointestinal-bleeding. With regard to the psychomotor symptoms and the coma depth, the clinical picture is classified into five grades (West Haven criteria). Diagnosis is made by clinical examination of the mental status after relevant differential diagnoses have been excluded. The only causal therapeutic option in the presence of acute or chronic liver failure is liver transplantation. Therefore, the indication for transplantation has to be evaluated in all forms of HE. Symptomatic treatment has three principal aims: (1) stabilization of circulation, oxygen supply, blood sugar and nutrition; (2) identification of the precipitating factor and its removal; (3) reduction of ammonia and other potential toxins in the circulation. In the case of acute HE, these therapeutic aims are complemented by an effective prophylaxis or therapy of brain edema.

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Bacterial infections associated with hepatic encephalopathy: Prevalence and outcome

Cited by 40 publications

References 23 publications

Increased risk of cognitive impairment in cirrhotic patients with bacterial infections

Increased risk of cognitive impairment in cirrhotic patients with bacterial infections

The intestinal flora and bacterial infection in cirrhosis

Hepatische Enzephalopathie

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