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- Usually inflammatory and noninfectious.
- If infectious, frequently polymicrobial. Leading pathogens:
- Pathogenicity is unclear for organisms cultured in bile/gall bladder unless also recovered in blood.
- Anaerobes are less significant unless bile duct to bowel anastomosis or fistula present; if so, the most common organisms include Clostridium and Bacteroides species.
- Pathogenic role of enterococci and anaerobes are otherwise not well defined and empirical coverage not usually required.