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Ann Hepatol 2022 May 9:100708. Epub 2022 May 9.

Metabolic Unit, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" ["Salvador Zubirán" National Institute of Medical Sciences and Nutrition], Mexico City, Mexico. Electronic address:

Cirrhosis is characterized by a prolonged asymptomatic period in which the inflammation persists, increasing as the disease progresses. Proinflammatory cytokines and pro-oxidant molecules are key in the development of organ dysfunction. Cirrhosis progression and worsening of portal hypertension bring about bacterial translocation and systemic dissemination via portal circulation of bacterial products, and molecular patterns associated with damage, which exacerbate the systemic Inflammation. Read More

J Clin Exp Hepatol 2022 Mar-Apr;12(2):519-532. Epub 2021 May 12.

Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.

Background: Spontaneous bacterial peritonitis (SBP) is a bacterial infection associated with a high mortality rate in cirrhotic patients. The gold standard for the detection of SBP is a manual cell count from ascitic fluid; however, alternative screening methods are under investigation. In particular, leukocyte esterase reagent strips (LERS) has been studied as an alternative method to detect SBP with a low cost and instant turnaround time. Read More

J Clin Exp Hepatol 2022 Mar-Apr;12(2):398-408. Epub 2021 Jul 21.

Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.

Background & Aims: There is no "gold standard" tool for the assessment of frailty in cirrhosis. This study compares Liver Frailty Index (LFI), Short Physical Performance Battery (SPPB), Fried Frailty Criteria (FFC), and Clinical Frailty Scale (CFS) for frailty assessment and ascertains its impact on predicting mortality and hospitalizations in a cohort of outpatients with cirrhosis.

Methods: 116 patients were enrolled in this prospective observational cohort study. Read More

J Clin Exp Hepatol 2022 Mar-Apr;12(2):575-594. Epub 2021 Sep 16.

Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Science, Bhubaneswar, Odisha, India.

Hyponatremia is the most common electrolyte abnormality in patients with decompensated cirrhosis on Liver Transplantation (LT) waiting list. Most of these patients have dilutional or hypervolemic hyponatremia secondary to splanchnic vasodilatation. Excessive secretion of the antidiuretic hormone also plays an important role. Read More

J Clin Exp Hepatol 2022 Mar-Apr;12(2):278-286. Epub 2021 Sep 10.

Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.

Background: Diagnosis and management of tuberculosis (TB) in patients with cirrhosis remains challenging. We studied the clinical spectrum, diagnosis, and management of TB along with the assessment of the diagnostic utility of various laboratory investigations in this cohort.

Methods: A retrospective review of records of patients with cirrhosis (July 2017 and December 2019) was done. Read More

J Clin Exp Hepatol 2022 Mar-Apr;12(2):336-342. Epub 2021 Aug 18.

Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.

Background: Spontaneous bacterial peritonitis (SBP) heralds increased mortality in cirrhosis, mandating strategies for prophylaxis. Norfloxacin has been the recommended choice for SBP prevention. However, its use has raised concerns about antibiotic resistance. Read More

Cureus 2022 Apr 5;14(4):e23851. Epub 2022 Apr 5.

Internal Medicine, University of Missouri, Kansas City School of Medicine, Kansas City, USA.

Umbilical hernia is a relatively common complication developing in patients with liver cirrhosis with recurrent ascites. Abdominal paracentesis is considered the mainstay procedure to manage refractory ascites and to diagnose spontaneous bacterial peritonitis. Incarceration of umbilical hernia is a rare but serious adverse event following therapeutic paracentesis that requires prompt management. Read More

Cureus 2022 Apr 3;14(4):e23774. Epub 2022 Apr 3.

Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, New York, USA.

Ischemic colitis is one of the most common ischemic pathologies of the gastrointestinal system and can be divided into non-gangrenous and gangrenous forms. The pathophysiology involves restricted blood supply to the colonic mucosa. Several risk factors have been implicated in the development of ischemic colitis. Read More

Rev Esp Enferm Dig 2022 Apr 29. Epub 2022 Apr 29.

Gastroenterology, University of Health Sciences Sultan 2. Abdulhamid, Turkey.

Ascites is the most common complication of the decompansated cirrhosis. The most common organisms isolated in patients with ascidic fluid infections and spontaneous bacterial peritonitis (SBP) are intestinal pathogens including Escherichia coli, Gram-positive cocci (mainly Streptococcus species) and Enterococci. As an infectious pathogen Vagococcus spp. Read More

United European Gastroenterol J 2022 May 28;10(4):409-424. Epub 2022 Apr 28.

Department of Internal Medicine III, University Hospital RWTH Aachen, RWTH Aachen University, Aachen, Germany.

Background And Objective: International registries have reported high mortality rates in patients with liver disease and COVID-19. However, the extent to which comorbidities contribute to excess COVID-19 mortality in cirrhosis is controversial.

Methods: We used the multinational Lean European Open Survey on SARS-CoV-2-infected patients (LEOSS) to identify patients with cirrhosis documented between March 2020 and March 2021, when the wild-type and alpha variant were predominant. Read More

Dig Dis Sci 2022 Apr 25. Epub 2022 Apr 25.

Sanford School of Medicine, University of South Dakota, Sioux Falls, USA.

Introduction: Administration of antibiotics in patients with cirrhosis and upper gastrointestinal bleeding has been shown to improve outcomes. Little is known regarding optimum duration of prophylactic antibiotics. Seven days of antibiotics are generally recommended but very few studies have compared antibiotic duration to clinical outcomes in current available scientific literature. Read More

BMJ Case Rep 2022 Apr 22;15(4). Epub 2022 Apr 22.

Division of Hospital Medicine, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA

Spontaneous bacterial peritonitis (SBP) is a common complication of liver cirrhosis and abdominal ascites, usually caused by organisms from the Enterobacteriaceae family. A woman in her 40s with a history of alcoholic liver cirrhosis presented to the hospital with dyspnoea, abdominal distention and diffuse abdominal pain. She was found to have sepsis and abdominal ascites, with elevated ascitic fluid neutrophil counts consistent with SBP. Read More

Vnitr Lek 2022 ;68(1):19-25

Liver cirrhosis represents a common condition with substantial mortality. Manifestation and progression of ascites, hepatic encephalopathy or gastrointestinal bleeding are among main reasons for hospital admission. Infections represent another specific area in cirrhotic patients. Read More

Ann Hepatol 2022 Apr 18;27(4):100711. Epub 2022 Apr 18.

Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus 8200, Denmark.

Introduction And Objectives: Spontaneous bacterial peritonitis (SBP) is a frequent complication to cirrhosis with an unclear long-term prognosis. We aimed to examine its effect on mortality in two independent patient cohorts.

Patients And Methods: We used Danish healthcare data on cirrhosis patients with a first-time paracentesis in 2000-2014 and data from three randomized controlled trials on satavaptan treatment of ascites conducted in 2006-2008. Read More

PLoS Negl Trop Dis 2022 Apr 20;16(4):e0010364. Epub 2022 Apr 20.

Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.

Although Q fever has been widely reported in the rural areas of China, there is a paucity of data on the epidemiology and clinical characteristics of this disease in large metropolitan cities. In this study, we profile the epidemiology and clinical manifestations of Q fever from a tertiary hospital in Shenzhen, a Southern Chinese metropolitan city with a large immigrant population from other parts of China. A total of 14 patients were confirmed to have Q fever during a nine-year-and-six-month period, five of whom were retrospectively diagnosed during case review or incidentally picked up because of another research project on unexplained fever without localizing features. Read More

Eur Rev Med Pharmacol Sci 2022 Apr;26(7):2220-2221

Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.

Arq Gastroenterol 2022 Jan-Mar;59(1):102-109

Hospital Português da Bahia, Unidade de Gastroenterologia e Hepatologia, Salvador, BA, Brasil.

Background: Bacterial infections occur in 43-59% of cirrhotic patients admitted to the intensive care unit with impact in morbidity and mortality. An increase in the frequency of multidrug-resistant (MDRO) and extensively drug-resistant (XDRO) organisms has been described in bacterial infections in cirrhotic patients with an adverse impact on survival.

Objective: To characterize community-acquired (CA), healthcare-associated (HCA), and hospital-acquired (HA) infections in cirrhotic patients and their impact in the occurrence of adverse outcomes. Read More

BMC Nephrol 2022 04 18;23(1):149. Epub 2022 Apr 18.

Department of Medicine, Renal Unit, United Christian Hospital, 130 Hip Wo Street, Kwun Tong, Kowloon, Hong Kong.

Background: Eosinophilic peritonitis is a well-known complication at the initiation of peritoneal dialysis. It is often due to an allergic reaction to peritoneal dialysis solution or sometimes to the peritoneal dialysis catheter itself. Most cases are self-limiting with expected spontaneous resolution within a few weeks. Read More

Indian J Pathol Microbiol 2022 Apr-Jun;65(2):513-514

Department of Microbiology, PSGIMSR, Coimbatore, Tamil Nadu, India.

Clin Exp Hepatol 2022 Mar 23;8(1):29-35. Epub 2022 Mar 23.

Hepatology Department, Faculty of Medicine, Alexandria University, Egypt.

Aim Of The Study: To evaluate the diagnostic performance of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), albumin-bilirubin ratio (ABR) and albumin-bilirubin score (ALBI) in different outcomes of liver cirrhosis, including decompensated liver cirrhosis (DLC), acute-on-chronic liver failure (ACLF), hepatocellular carcinoma (HCC), and spontaneous bacterial peritonitis (SBP). A second objective was to find their cut-off values. Finally, we aimed to correlate these indices with the severity of liver cirrhosis. Read More

Gastroenterology Res 2022 Feb 17;15(1):26-32. Epub 2022 Feb 17.

Department of Gastroenterology and Hepatology, Geisinger Medical Center, Danville, PA, USA.

Background: Hemorrhagic ascites is characterized as red blood cell count greater than 10,000/mm. In cirrhosis, ascites is an event of decompensation, and associated with poor prognosis. However, significance of hemorrhagic ascites is unclear. Read More

J Dig Dis 2022 Mar 31. Epub 2022 Mar 31.

Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China.

In this systematic and comprehensive overview, we aimed to evaluate the impact of proton pump inhibitors (PPIs) on chronic liver diseases, especially on cirrhosis. A manual and comprehensive search of the PubMed database was conducted to obtain relevant literatures. PPIs altered the composition and function of the intestinal microflora and might lead to small intestinal bacterial overgrowth and bacterial translocation, which were associated with adverse effects in liver diseases. Read More

Ochsner J 2022 ;22(1):100-103

Department of Hospital Medicine, Ochsner Clinic Foundation, Ochsner Medical Center - West Bank Campus, Gretna, LA.

Spontaneous bacterial peritonitis (SBP) is a life-threatening condition classically found as a complication of cirrhotic ascites, but it has rarely been documented in a case of nonportal hypertensive ascites. We report the case of a 54-year-old male with SBP arising from nonportal hypertensive ascites in the setting of end-stage renal disease and restrictive cardiomyopathy, both secondary to primary amyloidosis (AL type, kappa light chain). Peritoneal fluid analysis showed a serum-ascites albumin gradient of 1. Read More

Eur J Gastroenterol Hepatol 2022 Jun 29;34(6):655-663. Epub 2022 Mar 29.

Medical Microbiology and Immunology Department.

Background: The serious nature of spontaneous bacterial peritonitis (SBP) in patients with cirrhosis and the need for timely effective empirical antibiotic therapy in the context of the global surge of antimicrobial resistance and changing epidemiology necessitate a periodic review of the local epidemiologic features of the disease.

Aim: The aim of the study is to investigate the differences in bacterial profile and antibiotic resistance between nosocomial and community-acquired SBP in patients with liver cirrhosis to guide empirical antibiotic choices for better outcomes.

Methods: This cross-sectional study included 95 ascitic cirrhotic patients diagnosed with SBP. Read More

Int Immunopharmacol 2022 Mar 26;108:108729. Epub 2022 Mar 26.

Digestive Disease Center, Department of Hepatopancreatobiliary Medicine, The Second Hospital, Jilin University, Changchun, Jilin Province 130041, People's Republic of China. Electronic address:

Interleukin (IL) -35 induces immunotolerance by suppression of CD8 T cells during chronic infections and cancers. In the present study, we amined to investigate the role of IL-35-mediated regulation of CD8 T cells in patients with liver cirrhosis. Seventy-one patients with liver cirrhosis (46 patients with untainted ascites and 25 patients with spontaneous bacterial peritonitis [SBP]) and 22 controls were enrolled. Read More

Hepatol Int 2022 Apr 28;16(2):433-446. Epub 2022 Mar 28.

Department of Hepatology, Postgraduate Institute of Medical Education and Research Chandigarh, Chandigarh, India.

Background: Severe alcoholic hepatitis (SAH) presenting as acute-on-chronic liver failure (ACLF) carries a high short-term mortality. Alteration of gut microbiota is a crucial component implicated in its pathogenesis, whose modulation has been suggested as a potential therapeutic tool. We evaluated the safety of fecal microbiota transplantation (FMT) and its efficacy in improving short-term survival and clinical severity scores in patients with SAH-ACLF. Read More

Cureus 2022 Feb 9;14(2):e22051. Epub 2022 Feb 9.

Internal Medicine, Medical College of Wisconsin, Milwaukee, USA.

Spontaneous bacterial peritonitis (SBP) is a severe complication of ascites often seen in advanced hepatic disease that is most commonly caused by Gram-negative bacilli. Here, we report a rare case of SBP, diagnosed by peritoneal fluid culture and responsive to ampicillin, in a patient with portal hypertension secondary to nodular regenerative hyperplasia. Because Listeria species are resistant to empiric SBP therapies and delays in treatment have been associated with increased mortality, they must be considered in high-risk patients. Read More

Ann Ib Postgrad Med 2021 Jun;19(1):82-86

Hepatobiliary division, Department of Medicine, University College Hospital, Ibadan.

A preperitoneal abscess is an uncommon manifestation of extraperitoneal collection. We present a case of an anterior abdominal wall preperitoneal abscess in a 30-year-old Nigerian female with abdominal pain and purulent abdominal wall discharge ten days after an initial admission for spontaneous bacterial peritonitis. This report underscores the role of ultrasound in diagnosis and follow-up and percutaneous ultrasound-guided continuous percutaneous catheter drainage and management of an extraperitoneal abscess. Read More

Am J Case Rep 2022 Mar 23;23:e935198. Epub 2022 Mar 23.

Department of Critical Care Medicine, St. Joseph's University Medical Center, Paterson, NJ, USA.

BACKGROUND Sepsis is a leading global cause of mortality, with the most common causative agents being Staphylococcus aureus, Streptococcus pneumoniae, and Escherichia coli. In septic patients with liver cirrhosis, the mortality rates are higher than in the general population due to altered liver function and an excessive innate immune response. In this demographic, sepsis is typically caused by spontaneous bacterial peritonitis or urinary tract infections and the causative agents are very predictable owing to known dysregulated immunological pathways studied in patients with cirrhosis. Read More

J Gastrointestin Liver Dis 2022 03 19;31(1):40-47. Epub 2022 Mar 19.

Department of Anesthesia and Intensive Care I, University of Medicine and Pharmacy "Iuliu Hatieganu" , Cluj-Napoca, Romania; Anesthesia and Intensive Care Department, Prof. Dr. Octavian Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania; Outcome Research Consortium Department Cleveland, USA.

Background And Aims: Bacterial infections are associated with high mortality rates in patients with decompensated cirrhosis. Early diagnosis with the available diagnostic tools is challenging. Metabolomics is a novel technique with a widespread application in hepatology. Read More