Objective:To investigate the occurrence of invasive fungal infections（IFI）

clinical features and antifungal therapeutic effect in end-stage liver disease patients

to get better curative effect and prognosis. Methods:Risk factors

clinical manifestation

blood routine

G test

imageology

mycology characteristic

timing and effectiveness of antifungal treatment prescription in 102 end-stage liver disease patients with IFI were retrospectively analyzed. Antifungal therapeutic effect was compared among fluconazole

voriconazole and caspofungin. Results:Among 102 IFI patients

28 cases were diagnosed as proven IFI

29 probable cases

45 possible cases. The infectious sites were in abdominal cavity 50 cases

lung 37 cases

blood stream 8 cases

the central nervous system 4 cases

both lung and abdominal cavity 4 cases

respectively. All the patients were administered 1-2 courses of broad-spectrum antibiotics.Partial patients received glucocorticoid or other immunodepressants for a relatively long time. Eighty-two cases had G tests positive before antifungal treatment. Fifty-eight of 102 cases had hairy leukoplakia in oral cavity

and fungi were founded in those stains.Fifty-eight cases（56.9%）had peripheral blood white cells more than 10×10

9

/L

and 79 cases（77.5%）had neutrophilic granulocyte more than 80%. Twenty-nine cases had pulmonary lesions in CT scan. Seventeen patients were administered fluconazole

10 of them（58.8%）were effective

the other 7 patients were invalid;23 patients were administered voriconazole

15 of them（65.2%）were effective

the other 8 patients were invalid;58 patients were administered caspofungin

46 of them（79.3%） were effective

the other 12 patients were invalid. It seemed that caspofungin had the highest rate of effectiveness

but there was no statistic difference among the drugs. Conclusion:There are high risk factors in end-stage liver disease patients complicated with IFI. The most common pathogens were Candida spp. Signs and symptoms of IFI were atypical in the patients with end-stage liver disease. Delayed diagnosis and treatment in patients with these infections may contribute to a high fatality rate. Thus

clinicians should have a high index of suspicion for this unusual but lethal entity

as prompt detection and appropriate treatment can improve the outcome. Among the drugs available for IFI

caspofungin shows highest effect and safety

and can be used in end-stage liver disease.