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©2014 Baishideng Publishing Group Inc.
World J Hepatol. Sep 27, 2014; 6(9): 632-642
Published online Sep 27, 2014. doi: 10.4254/wjh.v6.i9.632
Published online Sep 27, 2014. doi: 10.4254/wjh.v6.i9.632
Table 1 Mechanism of Jaundice in Sepsis
Increased bilirubin load |
Hemolysis |
Red blood cells lysed by bacterial products (e.g., exotoxin) |
Red blood cells lysed by immunological mechanisms |
Hepatic dysfunction |
Hepatocellular injury (hepatitis and/or necrosis) |
Hepatic ischemia |
Decreased bilirubin uptake; dysfunction of basolateral transport (e.g., NTCP) |
Decreased transport of conjugated bilirubin; dysfunction of canalicular transport (e.g., BSEP, MRP2) |
Decreased bile flow |
Table 2 Foodbrone pathogens and manifestations
Pathogens | Manifestations |
Bacteria | |
Staphylococcus aureus | Vomiting (exotoxin), toxic shock syndrome |
Clostridium spp | |
C. botulinumC. perfringens | Neurogenic finding (paralysis) Diarrhea, gas gangrene, intravascular hemolysis, jaundice, liver abscess, gas in the portal vein |
Campylobacter spp | |
C. jejuni | Inflammatory diarrhea, liver injury (possible) |
C. fetus | Systemic, liver injury (possible) |
Escherichia coli | |
Enterotoxigenic E. coli | Inflammatory diarrhea |
Enterohemorrhagic E coli | Inflammatory diarrhea, hemolytic uremic syndrome |
Listeria monocytogens | Systemic (Listeriosis), elevated aminotransferases |
Salmonella spp | |
Non-typhoidal | Inflammatory diarrhea Systemic (Typhoid fever), acute hepatitis (Salmonella hepatitis) |
S.typhiS.paratyphi | |
Shigella spp | Inflammatory diarrhea, cholestatic hepatitis |
Vibrios spp | |
V. cholera | Watery diarrhea |
V. parahemolyticus | Inflammatory diarrhea |
V. vulnificus | Systemic (sepsis, DIC) |
Yersina entrrocolitica | Inflammatory diarrhea, multiple liver abscesses |
Virus | |
Hepatitis A | Acute hepatitis, jaundice |
Hepatitis E | Acute hepatitis, jaundice |
Norovirus | Vomiting, watery diarrhea |
Rotavirus | Vomiting, watery diarrhea |
Table 3 Frequency of symptoms and signs in salmonella and acute viral hepatitis A
Table 4 Comparison of clinical features of hepatitis caused by various viruses
n | Median age (range) | ALT (U/L) | ALP (U/L) | Bilirubin (μmol/L) | Lymphocyte count (× 109/L) | Lymphocytosis n (%) | |
EBV | 17 | 40 (18-68) | 395 (87-1362) | 345 (160-756) | 74 (13-165) | 6.91 (3.77-24.82) | 17 (100) |
HAV | 11 | 44 (20-61) | 1056 (595-4122) | 231 (91-342) | 154 (42-214) | 2.16 (1.23-4.1) | 1 (9) |
HBV | 16 | 39 (20-60) | 1858 (499-3856) | 230 (93-406) | 122 (36-355) | 2.00 (1.26-3.52) | 2 (12.5) |
HEV | 20 | 63 (54-81) | 1387 (318-6357) | 192 (139-464) | 61 (8-297) | 1.89 (0.96-10.25) | 5 (25) |
Table 5 Parasitic infection of the liver
Disease (organism) | Organs/status | Clinical presentation |
Malaria (P. falciparum, malariae, vivax, ovale) | Pre-erythrocytic phase | Asymptomatic |
Erythrocytic phase | Anemia, jaundice, mild elevation of aminotransferases, tender hepatomegaly, splenomegaly | |
Amebiasis (Entameba histolytica) | Intestine Amebic liver abscess | Right upper quadrant pain, fever, hepatomegaly (50%), jaundice (< 10%) |
Cystic echinococcosis (Echinococcus granulosus) | Single cyst (> 70%), < 10 cm and no complication Size up (1-5 cm/year), > 10 cm Rupture | Asymptomatic Abdominal pain, mass effect (possible) Peritonitis, hypersensitivity reactions |
Alveolar echinococcus (E. multilocularis) | Malaise, tender hepatomegaly, eosinophilia, obstructive jaundice, portal hypertension | |
Schitosomiasis (S. mansoni, japonicum) | Acute phase Chronic phase | Eosinophilic infiltrate Presinusoidal portal hypertension, splenomegaly, gastroesophageal varices |
Fascioliasis (F. hepatica) | Acute phase Chronic phase | Abdominal pain, fever, hemobilia, hepatomegaly Biliary colic, cholangitis, cholelithiasis, obstructive jaundice |
Ascariasis (A.lumbricoides) | Abdominal pain, fever, obstructive jaundice |
- Citation: Minemura M, Tajiri K, Shimizu Y. Liver involvement in systemic infection. World J Hepatol 2014; 6(9): 632-642
- URL: https://www.wjgnet.com/1948-5182/full/v6/i9/632.htm
- DOI: https://dx.doi.org/10.4254/wjh.v6.i9.632