CIRRHOSIS - A RISK FACTOR FOR CRYPTOCOCCAL PERITONITIS

Cryptococcal peritonitis is usually associated with end-stage renal di sease and peritoneal dialysis, Significant liver disease has not been well recognized as a risk factor for its development, We report two pa tients with cirrhosis who developed peritoneal infections with Cryptoc occus neoformans, We also retrospectively review all cases of cryptoco ccal illness at the Ohio State University Medical Center from October 1990 to January 1994 and present a review of the literature regarding cryptococcal peritonitis associated with hepatic dysfunction, Cirrhoti c patients with this entity present with subtle, nonspecific complaint s resulting in delayed diagnoses, dissemination, and death, We suggest that clinicians maintain an increased awareness of this unusual but l ethal entity in patients with liver impairment, Early and frequent abd ominal paracenteses with bedside inoculations of fungal culture medium , India ink preparations, and serum cryptococcal antigen testing may h asten the diagnosis and institution of appropriate therapy.