Eighty-four patients with bacteremia were surveyed prospectively for biochemical markers of liver damage. Aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and bilirubin levels were elevated in 44 (53%), 39 (47%), 45 (54%), and 5 (6%) of the patients on the first determination (2.0 +/- 0.1 days after onset of fever) and in 11 (13%), 17 (20%), 26 (31%), and 1 (1%) on the second determination (5.4 +/- 0.2 days after onset of fever), respectively. The elevation rarely exceeded three times the upper limit of normal. One patient had severe jaundice. An abnormality of at least one of these values was found in 55 patients (65%). There were no differences in site of infection, bacteria isolated, and outcome between patients with and without biochemical abnormalities. We conclude that in adult patients with bacteremia, elevation of liver enzymes and bilirubin is common, usually mild, of short duration, and of no prognostic significance.