Fungal infection in acute necrotizing pancreatitis

Martin Grewe, Gregory G. Tsiotos, Enrique Luque De-Leon, Michael G. Sarr

Research output: Contribution to journalArticle

97 Citations (Scopus)

Abstract

Background: Anecdotal reports suggest that patients with fungal infection of necrotizing pancreatitis (NP) have worse outcomes than those with bacterial infection. Our aim was to compare the clinical course and outcomes of patients with NP infected with fungal versus nonfungal organisms. Study Design: Prospectively collected data on 57 patients with infected NP (1983-1995) were reviewed. Results: Seven patients (12%) developed fungal infection, and 50 (88%) developed bacterial infection. Groups had similar mean ages (60 versus 63 years) and APACHE-II scores on admission (9 each). The cause of NP was ERCP-induced in 3 of 7 with fungal infection versus 3 of 50 with bacterial infection. Patients with fungal infection had been treated with a mean of 4 different antibiotics for a mean of 23 days, and 4 of 7 (57%) required mechanical ventilation preoperatively. In addition, postoperative ICU stays were longer (20 versus 10 days), as were total hospital stays (59 versus 41 days). Mortality was higher with fungal infection; 3 of 7 patients (43%) died versus 10 of 50 patients (20%). Conclusions: Although NP presents with similar initial severity, patients with fungal infection of NP tend to have a more complicated course and worse outcomes compared with those with bacterial infection. Low-dose antifungal prophylaxis should be added to early management of NP.

Original languageEnglish (US)
Pages (from-to)408-414
Number of pages7
JournalJournal of the American College of Surgeons
Volume188
Issue number4
DOIs
StatePublished - 1999

Fingerprint

Acute Necrotizing Pancreatitis
Mycoses
Pancreatitis
Bacterial Infections
APACHE
Endoscopic Retrograde Cholangiopancreatography
Artificial Respiration
Length of Stay
Anti-Bacterial Agents
Mortality

ASJC Scopus subject areas

  • Surgery

Cite this

Fungal infection in acute necrotizing pancreatitis. / Grewe, Martin; Tsiotos, Gregory G.; Luque De-Leon, Enrique; Sarr, Michael G.

In: Journal of the American College of Surgeons, Vol. 188, No. 4, 1999, p. 408-414.

Research output: Contribution to journalArticle

Grewe, M, Tsiotos, GG, Luque De-Leon, E & Sarr, MG 1999, 'Fungal infection in acute necrotizing pancreatitis', Journal of the American College of Surgeons, vol. 188, no. 4, pp. 408-414. https://doi.org/10.1016/S1072-7515(98)00334-2
Grewe, Martin ; Tsiotos, Gregory G. ; Luque De-Leon, Enrique ; Sarr, Michael G. / Fungal infection in acute necrotizing pancreatitis. In: Journal of the American College of Surgeons. 1999 ; Vol. 188, No. 4. pp. 408-414.
@article{3d8f01f19a754ee7ae0760076b8075c4,
title = "Fungal infection in acute necrotizing pancreatitis",
abstract = "Background: Anecdotal reports suggest that patients with fungal infection of necrotizing pancreatitis (NP) have worse outcomes than those with bacterial infection. Our aim was to compare the clinical course and outcomes of patients with NP infected with fungal versus nonfungal organisms. Study Design: Prospectively collected data on 57 patients with infected NP (1983-1995) were reviewed. Results: Seven patients (12{\%}) developed fungal infection, and 50 (88{\%}) developed bacterial infection. Groups had similar mean ages (60 versus 63 years) and APACHE-II scores on admission (9 each). The cause of NP was ERCP-induced in 3 of 7 with fungal infection versus 3 of 50 with bacterial infection. Patients with fungal infection had been treated with a mean of 4 different antibiotics for a mean of 23 days, and 4 of 7 (57{\%}) required mechanical ventilation preoperatively. In addition, postoperative ICU stays were longer (20 versus 10 days), as were total hospital stays (59 versus 41 days). Mortality was higher with fungal infection; 3 of 7 patients (43{\%}) died versus 10 of 50 patients (20{\%}). Conclusions: Although NP presents with similar initial severity, patients with fungal infection of NP tend to have a more complicated course and worse outcomes compared with those with bacterial infection. Low-dose antifungal prophylaxis should be added to early management of NP.",
author = "Martin Grewe and Tsiotos, {Gregory G.} and {Luque De-Leon}, Enrique and Sarr, {Michael G.}",
year = "1999",
doi = "10.1016/S1072-7515(98)00334-2",
language = "English (US)",
volume = "188",
pages = "408--414",
journal = "Journal of the American College of Surgeons",
issn = "1072-7515",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Fungal infection in acute necrotizing pancreatitis

AU - Grewe, Martin

AU - Tsiotos, Gregory G.

AU - Luque De-Leon, Enrique

AU - Sarr, Michael G.

PY - 1999

Y1 - 1999

N2 - Background: Anecdotal reports suggest that patients with fungal infection of necrotizing pancreatitis (NP) have worse outcomes than those with bacterial infection. Our aim was to compare the clinical course and outcomes of patients with NP infected with fungal versus nonfungal organisms. Study Design: Prospectively collected data on 57 patients with infected NP (1983-1995) were reviewed. Results: Seven patients (12%) developed fungal infection, and 50 (88%) developed bacterial infection. Groups had similar mean ages (60 versus 63 years) and APACHE-II scores on admission (9 each). The cause of NP was ERCP-induced in 3 of 7 with fungal infection versus 3 of 50 with bacterial infection. Patients with fungal infection had been treated with a mean of 4 different antibiotics for a mean of 23 days, and 4 of 7 (57%) required mechanical ventilation preoperatively. In addition, postoperative ICU stays were longer (20 versus 10 days), as were total hospital stays (59 versus 41 days). Mortality was higher with fungal infection; 3 of 7 patients (43%) died versus 10 of 50 patients (20%). Conclusions: Although NP presents with similar initial severity, patients with fungal infection of NP tend to have a more complicated course and worse outcomes compared with those with bacterial infection. Low-dose antifungal prophylaxis should be added to early management of NP.

AB - Background: Anecdotal reports suggest that patients with fungal infection of necrotizing pancreatitis (NP) have worse outcomes than those with bacterial infection. Our aim was to compare the clinical course and outcomes of patients with NP infected with fungal versus nonfungal organisms. Study Design: Prospectively collected data on 57 patients with infected NP (1983-1995) were reviewed. Results: Seven patients (12%) developed fungal infection, and 50 (88%) developed bacterial infection. Groups had similar mean ages (60 versus 63 years) and APACHE-II scores on admission (9 each). The cause of NP was ERCP-induced in 3 of 7 with fungal infection versus 3 of 50 with bacterial infection. Patients with fungal infection had been treated with a mean of 4 different antibiotics for a mean of 23 days, and 4 of 7 (57%) required mechanical ventilation preoperatively. In addition, postoperative ICU stays were longer (20 versus 10 days), as were total hospital stays (59 versus 41 days). Mortality was higher with fungal infection; 3 of 7 patients (43%) died versus 10 of 50 patients (20%). Conclusions: Although NP presents with similar initial severity, patients with fungal infection of NP tend to have a more complicated course and worse outcomes compared with those with bacterial infection. Low-dose antifungal prophylaxis should be added to early management of NP.

UR - http://www.scopus.com/inward/record.url?scp=0032907993&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032907993&partnerID=8YFLogxK

U2 - 10.1016/S1072-7515(98)00334-2

DO - 10.1016/S1072-7515(98)00334-2

M3 - Article

C2 - 10195725

AN - SCOPUS:0032907993

VL - 188

SP - 408

EP - 414

JO - Journal of the American College of Surgeons

JF - Journal of the American College of Surgeons

SN - 1072-7515

IS - 4

ER -