A recent review 1 of the records of 137 patients with bacteremia due to Gram-negative bacilli disclosed that 4 of the 137 patients had severe disease of the liver. This association seems more than coincidental and supports the views of Whipple and Harris.2 These authors reported four cases of Laennec's cirrhosis in which there was septicemia due to Escherichia (Bacterium) coli and postulated that a deficiency of effective reticuloendothelium in the cirrhotic liver, or changes in hepatic circulation, may account for the occurrence of septicemia in cirrhosis. Spellberg 3 and Beeson 4 have also commented on infections of the blood stream due to colon bacilli in patients with cirrhosis of the liver.
The purpose of our report is to describe four cases of severe hepatic disease complicated by bacteremia due to Gram-negative bacilli, in order to emphasize this complication further.
Report of Cases
—A 45-year-old man was