Hepatobiliary abnormalities associated with postanginal sepsis. Common manifestations of an uncommon disease

We describe eight patients with postanginal sepsis, a rare, potentially life-threatening complication of oropharyngeal infection. Six of the patients manifested jaundice, hepatomegaly, and liver function abnormalities, and in several this led to an erroneous suspicion of primary hepatobiliary disease. All eight patients survived the infection, although many suffered local or disseminated septic complications and required prolonged hospitalization. The pathophysiologic mechanisms responsible for hepatotoxicity in patients with postanginal sepsis are not understood. Physicians must be cognizant, however, of the frequent occurrence of jaundice in septicemic anaerobic processes, and this finding should not obscure the existence of postanginal parapharyngeal and jugular venous infection.