Isolated Conjugated Hyperbilirubinemia in Seriously Ill Children – Don’t Forget Sepsis!

Background: Jaundice is frequently associated with extrahepatic systemic infections. The important causes include increased bilirubin levels due to hemolysis, hepatic dysfunction, reduced excretion and cholestasis. Sepsis induced cholestasis has a unique pathophysiologic basis. Although common in gram negative sepsis among neonates, the clinical features of sepsis induced cholestasis are not widely recognized older children. Case report: We present a 6 year old, premorbidly asymptomatic boy with community acquired MRSA sepsis-pneumonia and ARDS (Acute respiratory distress syndrome) with isolated conjugated hyperbilirubinemia. A diagnosis of sepsis induced isolated cholestasis was considered after ruling out other possible causes of cholestasis. The hyperbilirubinemia improved with improvement in the primary pathology. Conclusion: Early recognition of sepsis as a cause of isolated cholestatic jaundice would avoid unnecessary investigations and therapy would help in early institution of appropriate therapy. Case Report Isolated Conjugated Hyperbilirubinemia in Seriously Ill Children – Don’t Forget Sepsis! Anirban Mandal1* and Amitabh Singh2 1Department of Pediatrics, Sitaram Bhartia Institute of Science and Research, New Delhi, India 2Department of Pediatrics, Chacha Nehru Bal Chikitsalaya, New Delhi, India Dates: Received: 14 November, 2016; Accepted: 05 December, 2016; Published: 06 December, 2016 *Corresponding author: Anirban Mandal, MD, DNB, Attending Consultant, Department of Pediatrics, Sitaram Bhartia Institute of Science and Research, B-16 Qutub Institutional Area, New Delhi 110016, India, Tel: 8826836670; E-mail: