Reviewer's report 
 Invasive Pulmonary Aspergillosis in Patients with decompensated cirrhosis : case series Title: 
 1  10 August 2006 Version: Date: 
 Jorge Garbino Reviewer: 
Reviewer's report: 
General 
1) The English medical writing should be edited throughout the manuscript for better comprehension, and 
some parts rewritten, especially the past medical history and the clinical evolution of the disease in the case reports. 
2) The diagnosis of Aspergillosis is not easy to establish for the readers because the information provided 
by the authors is not very well expressed. The authors must state clearly how they performed the diagnosis for each case. 3) For each case it is very difficult to find out the dose of voriconazole and the treatment duration. 
------------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached) 
CASE 1 
1) Were the diffuse infiltrates bilateral or unilateral? 
2) The patient was under antibiotic therapy, and this could be the reason why the microbiological results for 
the BAL specimen were negative. 
3) "Aspergillus serology was negative": Which test was used for Aspergillus serology? Please describe it. 
CASE 2 
1) Please specify the type of encephalopathy? Was it metabolic, septic, â€¦? 
2) Patient with severe pneumonia and sepsis. The patient didn't receive any antibiotic treatment? 3) Line 4: multiple organ failure = sepsis? 
4) Line 6: what was the dose of hydrocortisone hemisuccinate? 
5) From line 11: colonization? Quantification? Antibiotic treatment administered? 6) "antigen tests were positive": how many tests were performed and what were the results? 7) "Aspergillus serology was negative": Which test was used for Aspergillus serology? Please describe it. 
CASE 3 
1) Patient with urinary tract infection. The patient didn't receive any antibiotic treatment? 
2) First sentence: rewrite for more clarity. 
3) Lines 4-5: rewrite for more clarity. 4) "The Aspergillus antigen agglutination test": what was the method? ------------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
1) Title page, third author: is it Julien Massard or Massart? 
2) Antibiotics names must be written with lowercase letters. 
3) UNOS: please spell the acronym the first time it occurs (do the authors refer to United Network for Organ 
Sharing?) 
4) Child-Pugh Scale: it is "Child-Pugh Score", instead of "Scale". 
5) BIORAD: The right spelling is Bio-Rad (Platelia Aspergillus EIA for immunoenzymatic detection of 
galactomannan antigen of Aspergillus in serum; Bio-Rad, Marnes la Coquette, France). 6) Interactions with piperacillin-tazobactam: http://afssaps.sante.fr/htm/alertes/filalert/040302a.pdf 7) The neutrophil/leucocyte count is sometimes written with a comma (21,000, which is correct) and 
sometimes without (10100, which must be corrected). Please check the manuscript. 
BACKGROUND 
1) Line 5: among these were patients (add an "s")â€¦ 
CASE 1 
1) Line 11: because mycelia was identified. 
2) Line 12: The chest x-ray radiograph. 
DISCUSSION 
1) Second paragraph, lines 4-5: a hyphen is missing between "T" and "lymphocyte". 
 Reject because scientifically unsound What next?: 
 An article of limited interest Level of interest: 
 Not suitable for publication unless extensively edited Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests. 
Reviewer's report 
 Invasive Pulmonary Aspergillosis in Patients with decompensated cirrhosis : case series Title: 
 1  10 August 2006 Version: Date: 
 Jorge Garbino Reviewer: 
Reviewer's report: 
General 
1) The English medical writing should be edited throughout the manuscript for better comprehension, and 
some parts rewritten, especially the past medical history and the clinical evolution of the disease in the case reports. 
2) The diagnosis of Aspergillosis is not easy to establish for the readers because the information provided 
by the authors is not very well expressed. The authors must state clearly how they performed the diagnosis for each case. 3) For each case it is very difficult to find out the dose of voriconazole and the treatment duration. 
------------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached) 
CASE 1 
1) Were the diffuse infiltrates bilateral or unilateral? 
2) The patient was under antibiotic therapy, and this could be the reason why the microbiological results for 
the BAL specimen were negative. 
3) "Aspergillus serology was negative": Which test was used for Aspergillus serology? Please describe it. 
CASE 2 
1) Please specify the type of encephalopathy? Was it metabolic, septic, â€¦? 
2) Patient with severe pneumonia and sepsis. The patient didn't receive any antibiotic treatment? 3) Line 4: multiple organ failure = sepsis? 
4) Line 6: what was the dose of hydrocortisone hemisuccinate? 
5) From line 11: colonization? Quantification? Antibiotic treatment administered? 6) "antigen tests were positive": how many tests were performed and what were the results? 7) "Aspergillus serology was negative": Which test was used for Aspergillus serology? Please describe it. 
CASE 3 
1) Patient with urinary tract infection. The patient didn't receive any antibiotic treatment? 
2) First sentence: rewrite for more clarity. 
3) Lines 4-5: rewrite for more clarity. 4) "The Aspergillus antigen agglutination test": what was the method? ------------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
1) Title page, third author: is it Julien Massard or Massart? 
2) Antibiotics names must be written with lowercase letters. 
3) UNOS: please spell the acronym the first time it occurs (do the authors refer to United Network for Organ 
Sharing?) 
4) Child-Pugh Scale: it is "Child-Pugh Score", instead of "Scale". 
5) BIORAD: The right spelling is Bio-Rad (Platelia Aspergillus EIA for immunoenzymatic detection of 
galactomannan antigen of Aspergillus in serum; Bio-Rad, Marnes la Coquette, France). 6) Interactions with piperacillin-tazobactam: http://afssaps.sante.fr/htm/alertes/filalert/040302a.pdf 7) The neutrophil/leucocyte count is sometimes written with a comma (21,000, which is correct) and 
sometimes without (10100, which must be corrected). Please check the manuscript. 
BACKGROUND 
1) Line 5: among these were patients (add an "s")â€¦ 
CASE 1 
1) Line 11: because mycelia was identified. 
2) Line 12: The chest x-ray radiograph. 
DISCUSSION 
1) Second paragraph, lines 4-5: a hyphen is missing between "T" and "lymphocyte". 
 Reject because scientifically unsound What next?: 
 An article of limited interest Level of interest: 
 Not suitable for publication unless extensively edited Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests. 
Please review this paper.
user
Reviewer's report 
 Invasive Pulmonary Aspergillosis in Patients with decompensated cirrhosis : case series Title: 
 1  10 August 2006 Version: Date: 
 Jorge Garbino Reviewer: 
Reviewer's report: 
General 
1) The English medical writing should be edited throughout the manuscript for better comprehension, and 
some parts rewritten, especially the past medical history and the clinical evolution of the disease in the case reports. 
2) The diagnosis of Aspergillosis is not easy to establish for the readers because the information provided 
by the authors is not very well expressed. The authors must state clearly how they performed the diagnosis for each case. 3) For each case it is very difficult to find out the dose of voriconazole and the treatment duration. 
------------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached) 
CASE 1 
1) Were the diffuse infiltrates bilateral or unilateral? 
2) The patient was under antibiotic therapy, and this could be the reason why the microbiological results for 
the BAL specimen were negative. 
3) "Aspergillus serology was negative": Which test was used for Aspergillus serology? Please describe it. 
CASE 2 
1) Please specify the type of encephalopathy? Was it metabolic, septic, â€¦? 
2) Patient with severe pneumonia and sepsis. The patient didn't receive any antibiotic treatment? 3) Line 4: multiple organ failure = sepsis? 
4) Line 6: what was the dose of hydrocortisone hemisuccinate? 
5) From line 11: colonization? Quantification? Antibiotic treatment administered? 6) "antigen tests were positive": how many tests were performed and what were the results? 7) "Aspergillus serology was negative": Which test was used for Aspergillus serology? Please describe it. 
CASE 3 
1) Patient with urinary tract infection. The patient didn't receive any antibiotic treatment? 
2) First sentence: rewrite for more clarity. 
3) Lines 4-5: rewrite for more clarity. 4) "The Aspergillus antigen agglutination test": what was the method? ------------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
1) Title page, third author: is it Julien Massard or Massart? 
2) Antibiotics names must be written with lowercase letters. 
3) UNOS: please spell the acronym the first time it occurs (do the authors refer to United Network for Organ 
Sharing?) 
4) Child-Pugh Scale: it is "Child-Pugh Score", instead of "Scale". 
5) BIORAD: The right spelling is Bio-Rad (Platelia Aspergillus EIA for immunoenzymatic detection of 
galactomannan antigen of Aspergillus in serum; Bio-Rad, Marnes la Coquette, France). 6) Interactions with piperacillin-tazobactam: http://afssaps.sante.fr/htm/alertes/filalert/040302a.pdf 7) The neutrophil/leucocyte count is sometimes written with a comma (21,000, which is correct) and 
sometimes without (10100, which must be corrected). Please check the manuscript. 
BACKGROUND 
1) Line 5: among these were patients (add an "s")â€¦ 
CASE 1 
1) Line 11: because mycelia was identified. 
2) Line 12: The chest x-ray radiograph. 
DISCUSSION 
1) Second paragraph, lines 4-5: a hyphen is missing between "T" and "lymphocyte". 
 Reject because scientifically unsound What next?: 
 An article of limited interest Level of interest: 
 Not suitable for publication unless extensively edited Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests. 
assistant