Recognizing a cholangitis attack

Hey friends,
Being at University with newly diagnosed PSC during the worst flu season in years is tricky. My son is having flu symptoms…fever, aches, pains, headache etc. Any other year I would say hunker down, take Tylenol or Advil every 4-6 hours and push through. This year is a little more worrisome. How does Cholangitis present differently? Does it resolve on its own? Any info and advice is very appreciated. Also…his liver enzymes are pretty high right now. Vanco was started 10 days ago. Do liver enzymes rise with a cholangitis attack? Do they rise with the flu?

Hi TiCat,
Rule of thumb for Cholangitis attack. Chills and fever over 102. One thing I always had from my hepatologist was a full-filled prescription of Cipro in my night stand so if one came on me at night or the weekend I could begin treatment at home. If his gets over 102 I’d recommend he go to the ER but also tell them he has PSC. Check out this leaflet done by a PSC group in the UK which has some helpful information about this very subject.

Left untreated, bacterial cholangitis can cause serious complications such as sepsis. I’m not sure if the LFT levels rise with the flu or not.


Mark, thanks for your helpful response. He is getting bloodworm tomorrow. If colangitis is brewing would it show in blood work?

A number of factors could point to cholantitis including the following which I took for an online source. Hope this helps.

itching (pruritus)
dark urine
shivers and chills*
abdominal pain in the Right Upper Quadrant (RUQ)
pale stools
night sweats
*Fever, shivers and chills indicate a serious bacterial infection that needs urgent antibiotic treatment, although not all bacterial infections cause chills. Bacterial cholangitis in PSC may need medical attention even in the absence of fever or chills.

Bacterial Cholangitis: Top Tips
Keep a note of all your symptoms and how long you have had them.
Get an urgent appointment with a medical professional.
Expect to have an urgent blood test.
Expect to be given a broad-spectrum antibiotic such as ciprofloxacin.
Contact your usual PSC doctor immediately if you are at all unsure of your treatment or care.

I have had several cholangitis attacks and they all arrived in different manners.
Jaundice, pain and fever were present each time. I had a standing order that if my temp hit 101.5 with no apparent reason, get. to the ER. The time I had chills was when I had sepsis as well, so my body was telling me something different was happening.

Thanks Jeff. This looks like my son was battling flu. He was checked today and bloods done. On the mend.