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Spontaneous Bacteraemia Cirrhosis — SCE Infectious Diseases MCQ

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HardHealthcare-Associated InfectionsSpontaneous Bacteraemia CirrhosisSCE Infectious Diseases

A patient with advanced cirrhosis develops pneumococcal bacteraemia without an evident focal infection. Which mechanism best explains this susceptibility?

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Correct answer: A — Combined hepatic-clearance, complement and gut-barrier dysfunction

The best answer is “Combined hepatic-clearance, complement and gut-barrier dysfunction”. Cirrhosis-associated immune dysfunction combines impaired hepatic clearance and opsonisation with gut-barrier failure and shunting, so genuine primary bacteraemia can occur even without ascites. Cirrhosis causes clinically important infection risk, and acute variceal bleeding requires prophylactic intravenous antibiotics alongside haemostatic care.

Reference: NICE NG50: cirrhosis in over 16s: https://www.nice.org.uk/guidance/ng50/chapter/Recommendations