Abstract: Objective To explore the distribution of pathogenic bacteria in patients with liver failure complicated with pulmonary fungal infection, and to compare the treatment effects of itraconazole and voriconazole in these patients, and their influence on immune function. Methods One hundred and sixteen patients with liver failure complicated with pulmonary fungal infection that were admitted between April 2018 and August 2020 were enrolled in this study. They were retrospectively analyzed on the distribution of pathogenic bacteria that they affected. The patients were divided into 2 groups according to the treatment method. 57 cases in the control group were treated with itraconazole, while 59 patients in the observation group were treated with voriconazole. The immune function, disease remission rate, and liver function were compared between these two groups of patients at different time points post treatment. Results In 116 patients with liver failure and pulmonary fungal infection, Cryptococcus neoformans infection was the most common, accounting for 49.14% of the patients, followed by Aspergillus and Mucor, accounting for 27.59% and 18.96%. Candida albicans was the most rare pathogen, accounting for 4.31% of the patients. There was no statistical difference between these two groups of patients at different time points post treatment (P>0.05). The observation group had CD3⁺ (60.46±2.65)%, CD4⁺ (34.46±2.65)% at 4 weeks after treatment, and CD3⁺ (62.41±2.43)%,CD4⁺ (3, 6.86±2.65)% at 8 weeks after treatment, which were higher than those of the control group. On the contrary, the CD8⁺ (20.13±2.36)% at 4 weeks, and CD8⁺ (19.12±2.33)% at 8 weeks after treatment were lower than those of the control group. Meanwhile, the disease remission rate of the observation group was 59.32% at 4 weeks after treatment, 74.58% at 6 weeks after treatment, and 81.36% disease remission rate at 8 weeks after treatment, all were higher than those of the control group (P<0.05). Conclusion In patients with liver failure and pulmonary fungal infection, Cryptococcus neoformans infection is the most common pathogen. Voriconazole treatment has no major impact on the liver. It can improve the immune function and increase the disease remission rate.

Key words: Liver failure, Lung, Fungal infection, Pathogenic bacteria, Voriconazole, Immune function