The bacteriology of recurrent pyogenic cholangitis and associated diseases.

Ninety-five patients with recurrent pyogenic cholangitis had a range of specimens taken at laparotomy for bacterial culture. Bacteria were isolated from 68% of cases. Escherichia coli was the predominant pathogen. Other aerobic and anaerobic intestinal bacteria were also isolated. Liver biopsy, bile and gallstones were the most rewarding specimens for culture. Infection was usually localized, but systemic infection occurred occasionally. The site of infection is probably in the liver parenchyma; however, the route by which intestinal bacteria invade the liver is not known. Sixty per cent of the cases of recurrent pyogenic cholangitis had gallstones and 20% were infected with Clonorchis sinensis.