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Suppurative cholangeitis is considered to be secondary to conditions allowing of infections, such as gallstones, obstructions of the bile ducts from various causes, parasitic worms and carcinoma and from wasting conditions, such as typhoid, cholera and pneumonia. The bacteria isolated have been streptococci, staphylococci, Escherichia coli. Bacillus typhosus, pneumococci and Clostridium Welchii, the latter sometimes occurring as a primary infection. The onset is usually vague and the condition not suspected until septic symptoms appear. It may begin with attacks of jaundice simulating catarrhal jaundice, in which it is insidious or begins acutely as a septic process without jaundice. As a rule pain is absent until late in the disorder. In most instances the condition resembles malignant disease, from which it differs in the diffuse and regular enlargement of the liver, septic symptoms including a marked leukocytosis and polynuclear cytosis, and rapidly developing serious illness. Even in the presence of jaundice from
Bassler A. PRIMARY SUPPURATIVE CHOLANGEITISREPORT OF A CASE AND THE VALV[ill]E OF LIVER REHABILITATION IN THERAPY. JAMA. 1937;109(11):864–866. doi:10.1001/jama.1937.92780370002012a