Primary Sepsis Presenting as Fulminant Hepatic Failure

Four patients who were referred to the Liver Failure Unit withan initial diagnosis of fulminant hepatic failure were foundto have severe bacterial infeclion from a primary septic focusas the cause of their illness. Clinical and biochemical characteristicswere not helpful in differentiating these patients from thosewith hepatic failure from other causes, and only a high degreeof suspicion will prevent delay in the diagnosis of underlyingsepsis and initiation of appropriate treatment. The possiblemechanisms respomible for this uncommon association are discussed.