Novel presentation and approach to management of hepatopulmonary syndrome with use of antimicrobial agents

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
R M Añel, J N Sheagren

Abstract

A 44-year-old man with hepatitis C-associated liver cirrhosis, cyanosis, digital clubbing, and platypnea presented with left-side hemiplegia found to be due to a brain abscess. Hepatopulmonary syndrome was diagnosed after demonstration of the presence of a massive intrapulmonary shunt. Although the anomalous vascular channel never was defined anatomically, follow-up studies confirmed the presence of a functional shunt. Culture of a sample from the abscess yielded Streptococcus intermedius. It was hypothesized that the patient's pulmonary vascular pathology was due, in large part, to chronic elevated levels of nitric oxide (a potent vasodilator thought to be generated by endotoxin absorbed from the gut). Treatment with oral norfloxacin was initiated on the basis of data that this antibiotic reduces endotoxemia and concomitant nitric oxide production in patients with cirrhosis. Four months after initiation of treatment, the patient's hypoxia had resolved.

References

Sep 1, 1977·Chest·T C Kennedy, R J Knudson
Jun 1, 1992·Internal Medicine·H ShijoM Okumura
Nov 1, 1992·Thorax·R Rodríguez-RoisinJ Roca
Aug 15, 1992·The American Journal of Cardiology·W E HopkinsB Barzilai
Mar 30, 1991·Lancet·P Vallance, S Moncada
Feb 1, 1992·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·J ClàriaJ Rodés
Jul 1, 1985·Antimicrobial Agents and Chemotherapy·H S WarrenG R Siber
Dec 1, 1968·Archives of Internal Medicine·E L Mazzaferri, G M Penn
Feb 10, 1966·The New England Journal of Medicine·P BerthelotL Reid
Jun 1, 1995·Digestive Diseases and Sciences·F C MorencosF Pons Romero
Jun 1, 1994·Journal of Hepatology·J M Pak, S S Lee
Nov 1, 1995·The European Respiratory Journal·G CremonaG J Jones
Mar 1, 1996·Clinics in Chest Medicine·P A Lange, J K Stoller
Mar 1, 1996·Clinics in Chest Medicine·M Castro, M J Krowka
Jul 1, 1996·Journal of Internal Medicine·R FinkelsteinJ A Hemli
May 13, 1998·Zeitschrift für Gastroenterologie·H P AllgaierH E Blum
May 15, 1998·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·T ChibaW Hida
Aug 26, 1998·The New England Journal of Medicine·P Y MartinR W Schrier
Nov 5, 1998·Journal of Clinical Gastroenterology·G A Abrams, M B Fallon
Sep 1, 1956·The American Journal of Medicine·F W HOFFBAUER, R RYDELL
Aug 1, 1957·The Journal of Clinical Investigation·P CALABRESI, W H ABELMANN
May 1, 1997·Clinics in Liver Disease·G A Abrams, M B Fallon

❮ Previous
Next ❯

Citations

Dec 3, 2010·Current Gastroenterology Reports·Rajan KocharMichael B Fallon
Nov 30, 2005·Current Treatment Options in Gastroenterology·Miguel R Arguedas, Michael B Fallon
Jun 12, 2004·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·G Rolla
Apr 26, 2003·Journal of Hepatology·Giovanni Rolla
Aug 13, 2004·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Mauro S TornoDarryl Y Sue
Sep 22, 2005·Journal of Gastroenterology and Hepatology·Benjamin SztrymfPhilippe Herve
Aug 21, 2002·American Journal of Respiratory and Critical Care Medicine·Anne RabillerPhilippe Hervé
Nov 17, 2012·American Journal of Respiratory and Critical Care Medicine·Jason S FritzSteven M Kawut
Oct 9, 2013·BioMed Research International·Ahad EshraghianSeung Kew Yoon
Jun 2, 2009·Gastroentérologie Clinique Et Biologique·T ThevenotJ Cadranel
Oct 14, 2011·International Journal of Hepatology·Prabha SawantM Nasa
Apr 1, 2014·Clinics in Liver Disease·David G Koch, Michael B Fallon
Sep 8, 2010·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Samir GuptaAhmed M Bayoumi
Dec 30, 2015·Pediatrics International : Official Journal of the Japan Pediatric Society·Keiichi MoritaKosaku Maeda
Aug 19, 2009·Pediatric Transplantation·Abdulrahman Al-HussainiAnil Dhawan
Aug 11, 2006·Journal of Hepatology·David T Palma, Michael B Fallon
Oct 7, 2005·Clinics in Liver Disease·Miguel R Arguedas, Michael B Fallon
Jan 30, 2015·Liver International : Official Journal of the International Association for the Study of the Liver·Sarah RaevensIsabelle Colle
Apr 5, 2015·Gastroenterología y hepatología·Antonio CuadradoJavier Crespo
Mar 4, 2015·Digestive Diseases and Sciences·Yong Lv, Daiming Fan
Aug 11, 2004·Southern Medical Journal·Syed Fayyaz Hussain, Sabeen Fatima Mekan
Apr 2, 2009·Seminars in Cardiothoracic and Vascular Anesthesia·Hanny YeshuaRan Oren
Jul 4, 2012·Nature Reviews. Gastroenterology & Hepatology·Junlan Zhang, Michael B Fallon
May 8, 2018·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Sarah Raevens, Michael B Fallon
Apr 8, 2015·World Journal of Hepatology·Hiroshi Fukui
May 6, 2011·Current Opinion in Organ Transplantation·Norman L SussmanMichael B Fallon
Jul 20, 2016·World Journal of Gastroenterology : WJG·Israel Grilo-Bensusan, Juan Manuel Pascasio-Acevedo
Mar 31, 2018·World Journal of Gastroenterology : WJG·Stergios SoulaidopoulosIoannis Goulis
Sep 30, 2019·Clinics in Liver Disease·Rodrigo Cartin-Ceba, Michael J Krowka

❮ Previous
Next ❯

Related Concepts

Related Feeds

Brain Abscess

Brain abscess is an accumulation of pus caused by inflammation and infected materials in the brain. Symptoms include fever, headache, seizures and other neurological problems. Discover the latest research on brain abscess today.

Related Papers

American Journal of Respiratory and Critical Care Medicine
A RabillerP Hervé
American Journal of Respiratory and Critical Care Medicine
H NunesP Hervé
The New England Journal of Medicine
G RollaL Brussino
Journal of Hepatology
G MartinezRobert Rodríguez-Roisin
© 2021 Meta ULC. All rights reserved