REVIEW Sepsis-Induced Cholestasis

Jaundice and hepatic dysfunction frequently accompany a variety of bacterial infections. The relationship between sepsis and jaundice, particularly in a pediatric population, was reported as early as 1837.1 Jaundice may result either directly from bacterial products or as a consequence of the host’s response to infection. Frequently, both factors contribute to the development of jaundice. In addition, specific infections that target the liver may cause jaundice because of the liver injury associated with hepatic infection. Although jaundice may be an isolated abnormality, it is often associated with features of cholestasis. In critically ill patients, the development of jaundice and/or cholestasis complicates the clinical picture and poses a clinical challenge both in diagnostic evaluation and in management. In this article, we review the current concepts about the pathogenesis of jaundice and cholestasis with infection, their clinical presentation and diagnostic assessment, and the optimal management of these clinical problems.