Liver failure, acute systemic infections

Organisms other than the viruses discussed earlier can cause acute liver infections, such as Leptospira icterohaemorrhagia, which causes Weil s disease, fungal infections caused by Candida species or aspergillosis, and schistosomiasis caused by trematodes. A number of systemic infections may also affect the liver, leading to jaundice, abnormal liver function tests or even acute liver failure. Table 3.6 lists some of the infective organisms that have been associated with liver disease. 

In acute myeloid leukaemia or lymphatic leukaemia as well as in acute leukaemic episodes in non-Hodgkin lymphoma, involvement of the liver may only be detectable clinically by the presence of hepatomegaly and subicterus. Laboratory parameters usually show slightly elevated transaminase as well as bilirubin values, and distinct cholestasis is occasionally observed. (7) Acute hepatic failure can occur during the course of acute leukaemia, (l, 8,26,65) Histologically, there are massive, yet uniform blast-cell infiltrates these are found mainly within the portal fields in acute lymphatic leukaemia (about 95%) and within the sinusoids in acute myeloid leukaemia (about 75%). Involvement of the liver is of no consequence with regard to the underlying disease and its therapy. Secondary infections require systemic treatment with antibiotics and/or antimycotics. 

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