Cholangitis

Always think about cholangitis in any ill-appearing patient with RUQ pain or undifferentiated sepsis.
Charcot’s triad and Reynold’s pentad are not reliable. Absence of these clinical findings does not rule out cholangitis. Use the total picture with clinical exam, labwork, and imaging studies.
Early antibiotics and consultation for biliary decompression are mainstays of therapy.

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