Severe alcoholic hepatitis (AH) has a poor short-term prognosis. Although infections are frequent complications of AH, the incidence of invasive aspergillosis (IA) and its impact on outcome remain unknown.We prospectively followed 94 biopsy-proven severe AH episodes for 3 months. We retrospectively reviewed our diagnosis of IA based on EORTC/MSG and AspICU criteria, except for host factors.Fifteen IA (6 proven, 8 probable, and 1 possible) were diagnosed after a median delay of 26 days following diagnosis of AH. The sites of infection were the lungs (n=11) and central nervous system (n=2), while IA was disseminated in 2 cases. Baseline MELD score ≥24 and ICU admission were independent risk factors for IA. Thirteen IA occurred in the context of corticosteroids, and 2 had received no specific treatment for AH. Non-response to corticosteroids at day 7 was not a risk factor for IA, but IA was associated with absence of liver improvement at day 28. Despite antifungal treatment, 3-month transplant-free survival of patients with IA was 0

作者：Thierry, Gustot；Evelyne, Maillart；Massimo, Bocci；Rudy, Surin；Eric, Trépo；Delphine, Degré；Valerio, Lucidi；Fabio Silvio, Taccone；Marie-Luce, Delforge；Jean-Louis, Vincent；Vincent, Donckier；Frédérique, Jacobs；Christophe, Moreno

来源：Journal of hepatology 2014 年 60卷 2期