title: Primary sepsis presenting as fulminant hepatic failure.
abstract: Four patients who were referred to the Liver Failure Unit with an initial diagnosis of fulminant hepatic failure were found to have severe bacterial infection from a primary septic focus as the cause of their illness. Clinical and biochemical characteristics were not helpful in differentiating these patients from those with hepatic failure from other causes, and only a high degree of suspicion will prevent delay in the diagnosis of underlying sepsis and initiation of appropriate treatment. The possible mechanisms responsible for this uncommon association are discussed.
authors.affiliation: Liver Unit, King's College Hospital, London.
authors.forename: L Y
authors.initials: LY
authors.lastname: Dirix
authors.forename: R J
authors.initials: RJ
authors.lastname: Polson
authors.forename: A
authors.initials: A
authors.lastname: Richardson
authors.forename: R
authors.initials: R
authors.lastname: Williams
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000150:complications* / Q000382:microbiology; D004239:Diverticulitis, Colonic / Q000150:complications / Q000175:diagnosis; D004927:Escherichia coli Infections / Q000150:complications; D005260:Female; D006501:Hepatic Encephalopathy / Q000209:etiology*; D006801:Humans; D008297:Male; D008585:Meningitis, Meningococcal / Q000150:complications; D008875:Middle Aged