Non-decompensated cirrhosis as a risk factor for invasive aspergillosis: a case report and review of the immune dysfunction of cirrhosis

Abstract

Invasive aspergillosis is a frequently insidious syndrome that carries a poor prognosis even when promptly and appropriately treated. Those patients that are identified as possessing risk factors for invasive aspergillosis are more likely to receive early therapy. Patients with profound immunosuppression, such as those with hematologic malignancy, iatrogenic immunosuppression for solid organ transplant, and advanced AIDS, are clearly at risk for invasive aspergillosis. Recently, invasive aspergillosis has been reported in patients with subtle immune dysfunction such as those with critical illness and advanced cirrhosis. However, patients with early cirrhosis also possess risk for invasive mycoses. We report a case of non-decompensated cirrhosis as the predisposition to invasive aspergillosis and review the immune dysfunction of cirrhosis that creates this risk.