Acalculous cholecystitis due to Salmonella enteritidis

Abstract

of stones. Traditionally, it was considered a fatal disease almost exclusively of critical ill patients; however, there are recent reports of cases of AAC affecting less severe patients with good prognosis treated with antibiotics, in the absence of cholecystectomy.We herein report a case of a young man who developed AAC after a Salmonella enteritidis gastrointestinal infection. CASE REPORTA 27-year-old man was admitted to hospital with abdominal pain, diarrhoea, persistent vomiting and 38℃ temperature. On physical examination, he was febrile, but in a good state of health. His abdomen was mildly tender to palpation with guarding in his lower right area. Laboratory tests disclosed a white cell count of 5300 × 1000/μL with 50% neutrophils and 32% lymphocytes, and haemoglobin and platelets were nor mal. The biochemical studies including liver and renal tests, electrolyte panel and coagulation profile, were normal. An abdominal X-ray film showed gas in several loops of a moderately dilated small bowel, and an abdominal sonography disclosed marked mucosal thickening in the right quadrant affecting ileon loops, cecum and ascending colon with small lymph node enlargement; the remainder of the abdominal contents, including the gallbladder were normal. Serology for Salmonella typhi H and O, Yersinia and Shigella were negative, as were blood cultures. The coproculture obtained on admission was positive for Salmonella enteritidis.The patient was treated with intravenous fluids, analgesics and antipyretics and became afebrile on the second day; in a week time, the abdominal pain subsided and he was able to restart oral diet so he was discharged from hospital.The following day he returned to the Emergency Department due to epigastric and right hypochondria pain, nausea and fever. He had no diarrhoea. On physical examination, he presented a temperature of 38℃, a tender upper abdomen, and Murphy's sign. The laboratory tests showed mild normocytic-normochromic anaemia with 7900 × 1000/μL white cells. The biochemical tests were normal. A new abdominal sonography disclosed normal intestinal loops, but his gallbladder was distended and presented a markedly thick wall (7 mm) with no stones, and was surrounded by a little fluid collection.He was then administered intravenous antibiotics AbstractAcute acalculous cholecystitis (AAC) is defined as an acute inflammation of the gallbladder in the absence of stones. We herein report a case of a young man who developed AAC after a Salmonella enteritidis gastrointestinal infection.

Salmonella chronic carriage: epidemiology, diagnosis, and gallbladder persistence

“…Clinical findings have implied long-term, relapsing infection reminiscent of carriage, and epidemiology studies indicate direct human-to-human transmission [96]. Hepatobiliary pathology is a sequela of acute NTS disease [97, 98], and abnormalities of the biliary tree have been implicated as a predisposing factor to development of iNTS in children [91], implying that bacterial colonization of this organ may be a factor in invasive NTS as well.…”

A Case Report of Acute Acalculous Cholecystitis and Acute Hemorrhagic Cystitis due to Salmonella Typhi

“…Typhoid fever, actinomycosis, parasitic infestations, and childhood diseases such as scarlet fever are among the rare causes of acalculous cholecystitis [8]. Acalculous cholecystitis due to Typhi is frequently reported in children in the endemic areas; however, it is rare in adults [9].…”

Colecistite Aguda Alitiásica por Salmonella enteritidis

“…A fisiopatologia não se encontra devidamente esclarecida, contudo, diversos fatores como isquemia, infeção e alterações estruturais e do conteúdo biliar estarão envolvidos. [1][2][3][4][5][6] Encontrava-se tipicamente associada a casos de prognóstico reservado, como doentes politraumatizados, queimaduras extensas e estados sépticos. 1,[4][5][6] No entanto, são cada vez mais os casos de colecistite aguda alitiásica descritos em outras situações, nomeadamente vasculites, como a doença de Kawasaki, e a várias infeções, como a infeção pelo vírus da hepatite A e vírus Epstein Barr.…”

“…Desta forma, o diagnóstico deverá ser estabelecido pelo enquadramento da clínica, avaliação analítica com os achados característicos à ecografia abdominal. [1][2][3][4] No caso apresentado, à semelhança de outros casos descritos, [2][3][4][5][6][7][8] o doente foi tratado de forma conservadora e apresentou evolução favorável. Realça-se um quadro de colecistite aguda alitiásica não associada a doença sistémica grave, reforçando a tendência atual, e ilustra--se que a gastroenterite por Salmonella não tifoide, dentro das diversas complicações descritas, poderá complicar-se com colecistite aguda alitiásica e que o diagnóstico deverá ser suspeitado face à persistência das queixas sugestivas.…”