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Liver and intrahepatic bile ducts-nontumor

Infectious (non-viral) disorders

Bacterial infections


Reviewers: Komal Arora, M.D. (see Reviewers page)
Revised: 27 June 2012, last major update May 2012
Copyright: (c) 2004-2012, PathologyOutlines.com, Inc.

See also Liver-pyogenic abscess

General
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● Causes large numbers of deaths in patients with liver disease (Int J Hepatol 2011;2011:784540)
● Due to cholestasis of sepsis, ascending cholangitis, post-transplant infection (Liver Transpl 2012;18:468)
or other bacterial infection of liver


Cholestasis of sepsis

General
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● Usually gram negative sepsis
● Diagnosis of exclusion

Micro description
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● Canalicular cholestasis, neutrophils in sinusoids, variable cholangiolar cholestasis

Micro images
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Ductular cholestasis

Differential diagnosis
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● Cholestatic drug reaction, early biliary obstruction (portal involvement), postoperative cholestasis, familial cholestatic syndromes


Bacterial infection of liver

General
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● Various bacterial species, including atypical mycobacteria (smaller epithelioid granulomas), Bartonella henselae (vascular proliferation simulates Kaposiís sarcoma or peliosis), Brucella (poorly formed sinusoidal granulomas), Listeria (poorly formed sinusoidal granulomas), Mycobacteria tuberculosis (giant cell granulomas with variable necrosis), congenital syphilis (pericellular fibrosis), Salmonella typhi (typhoid fever), Staphylococcus aureus (toxic shock syndrome)

Micro description
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● Sepsis in ICU patients: centrilobular necrosis (80%), steatosis (73%), portal inflammation (73%), lobular inflammation (67%), hepatocellular apoptosis (67%), cholangitis/cholangiolitis (20%, World J Gastroenterol 2008;14:1389)

Micro images
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Liver biopsies in patients dying of sepsis

End of Liver and intrahepatic bile ducts-nontumor > Infectious (non-viral) disorders > Bacterial infections


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