Cholestatic jaundice is a well recognised complication of late sepsis. However, cholestatic liver injury preceding sepsis is less well known and appreciated. This leads to delays in diagnosis in clinical practice and may result in significant morbidity and mortality. The development of a cholestatic blood picture should be considered as an early warning sign of an underlying infection, even in the absence of signs or symptoms of sepsis. This report describes the case of a previously healthy patient who presented with cholestatic jaundice. Staphylococcal osteomyelitis involving the left sacroiliac joint was diagnosed. Literature relating to cholestatic jaundice in sepsis is reviewed.

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