Biliary Sepsis

Question 1

What are the common causes of jaundice?

Answer 1

Gallstones
Alcohol hepatitis
Viral hepatitis
Pancreatitis

Question 2

What is Charcot’s triad?

Answer 2

A triad of fever, abdominal pain and jaundice which often indicates acute cholecystitis

Question 3

What are the most common bacteria associated with acute cholecystitis/biliary sepsis?

Answer 3

Gram negative organisms such as e.coli, klebsiella and enterobacter are most common. Gram positive organisms such as enterococcus and anaerobes such as bactericides and clostridium can also be seen

Question 4

What initial radiology investigations should be performed in all patients with suspected acute cholangitis / biliary sepsis?

Answer 4

Transabdominal ultrasound or abdominal CT

Question 5

What empirical antibiotic therapy would be recommended for the treatment of acute cholecystitis / biliary sepsis?

Answer 5

Triple therapy: IV amoxicillin, metronidazole and gentamicin

Question 6

A gram negative bacteraemia is likely not to be significant and just the result of a contaminant. T/F?

Answer 6

False - a gram negative bacteraemia is always significant