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The Evolving Challenge of Infections in Cirrhosis

List of authors.
  • Jasmohan S. Bajaj, M.D.,
  • Patrick S. Kamath, M.D.,
  • and K. Rajender Reddy, M.D.

Patients with cirrhosis are at increased risk for serious infections, including spontaneous bacterial peritonitis, multidrug-resistant infection, and infection with gut microorganisms. In-hospital mortality exceeds 50%. Empirical antibiotic coverage is used until a precise diagnosis can be made.

Funding and Disclosures

Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.

Dr. Bajaj reports receiving grant support, paid to his institution, from Valeant and Grifols; and Dr. Reddy, receiving grant support, paid to his institution, from Intercept, Conatus, Exact Sciences, Grifols, and Sequana, grant support and advisory board fees from AbbVie, Gilead, Merck, BMS, and Mallinckrodt, advisory board fees from Spark Therapeutics, Dova, and Shionogi, and data and safety monitoring board fees from Novartis. No other potential conflict of interest relevant to this article was reported.

We thank Drs. Nathan Cummins, Division of Infectious Diseases, and Alice Gallo De Moraes, Division of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine and Science, for critical review of an earlier version of the manuscript.

Author Affiliations

From Virginia Commonwealth University and Central Virginia Veterans Healthcare System, Richmond (J.S.B.); Mayo Clinic College of Medicine and Science, Rochester, MN (P.S.K.); and the University of Pennsylvania, Philadelphia (K.R.R.).

Address reprint requests to Dr. Reddy at the University of Pennsylvania, 2 Dulles, 3400 Spruce St., Philadelphia, PA 19104, or at .

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