Jaundice Associated With Bacteremia

In seven patients with clinical jaundice associated with bacteremia, hepatic function tests gave variable results; only hyperbilirubinemia was universally present. Values for serum alkaline phosphatase and glutamic oxaloacetic transaminase activity, when determined, were inconstant. Bacteremia was due to various gram-positive and gram-negative organisms, one patient having mixed flora. Pathologic hepatic changes were principally those of cholestasis, Kupffer cell hyperplasia, fatty metamorphosis, and focal necrosis of parenchymal cells; in most patients these changes were thought to represent nonspecific reactive hepatitis. In all patients, autopsy or surgical exploration demonstrated a normal biliary tract with no gross pathologic process involving the liver. Six of the seven died of the underlying illness and associated bacteremia. In the one survivor, the results of hepatic function tests became normal.