Severe Liver Disease Complicated by Bacteremia: Further Observations on Gram-Negative Bacilli

In 1950, Whipple and Harris¹ reported 4 cases of Laennec's cirrhosis in which there was bacteremia due to Escherichia coli. Spellberg² and Beeson³ have commented on infections of the blood stream due to colon bacilli in patients with cirrhosis of the liver. In 1954, members of our group⁴ noted cases of severe hepatic disease complicated by bacteremia due to E. coli. These were among the 4 such cases separately reported,⁵ and also were described in our study of 137 patients with bacteremia due to Gram-negative bacilli encountered in a 15-year period extending through 1954.⁶ Subsequently, other reports of this coincidence of diseases have been made.^7-12

Although bacteremia due to Gram-positive microorganisms may complicate severe hepatic disease, our experience to date suggests that it may occur less commonly than Gram-negative bacteremia. Only 1 of 143 patients with bacteremia due to Gram-positive organisms who were