In the context of cholangitis, what does Reynolds' pentad include in addition to Charcot's triad?

Reynolds' pentad expands upon Charcot's triad, which consists of fever, jaundice, and right upper quadrant pain, by adding two additional critical components: shock and mental status changes. This progression signifies a more severe manifestation of cholangitis, indicating the potential for septic shock due to the infection of the biliary tree.

The presence of shock reflects a systemic response to severe infection and can manifest as hypotension or altered consciousness. Mental status changes can include confusion or drowsiness, which occur as a result of either severe infection (sepsis) or inadequate perfusion of the brain.

This pentad is essential in clinical practice because it alerts healthcare providers to the severity of the condition and the need for immediate intervention to prevent complications.