Acute Acalculous Cholecystitis Associated with Epstein–Barr Infection: A Case Report and Review of the Literature

Ntelis, Konstantinos; Mazarakis, Dimosthenis; Sapountzis, Apostolos; Zissi, Dimitra; Sparangi, Sophia; Xidia, Nikoletta; Velissaris, Dimitrios

doi:10.1155/2020/9029601

Cited by 13 publications

(14 citation statements)

References 49 publications

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“…Acute acalculous cholecystitis is described as gallbladder inflammation without evidence of a stone and is usually encountered in critically ill, hospitalized patients. It makes up for 5%-10% of cases of all cholecystitis [ 3 ]. It is frequently associated with gangrene, perforation, and empyema, with a 10%-50% mortality rate in affected patients [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

A Curious Case of Acute Acalculous Cholecystitis

Hamid¹,

Zackria²,

Sharma³

2021

Cureus

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Acute acalculous cholecystitis is inflammation of the gallbladder without any evidence of gallstones. Although acalculous cholecystitis is less common than its calculous counterpart, it can be fatal if not treated. It is essential to rule out the cause of acalculous cholecystitis to aid in the treatment and management of the patient. We present a case of acalculous cholecystitis wherein a comprehensive workup found the etiology to be viral. Albeit rare, hepatitis A and cytomegalovirus can be causes of acute cholecystitis. Both viruses were observed simultaneously in this patient, proving it to be a unique case. This early diagnosis allowed conservative management of the patient, sparing him from unnecessary surgical intervention.

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Section: Discussionmentioning

confidence: 99%

A Curious Case of Acute Acalculous Cholecystitis

Hamid¹,

Zackria²,

Sharma³

2021

Cureus

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“…It has also been associated with the use of parenteral nutrition, post-surgery, extensive burns, and after trauma. In healthy patients such as the related case, this form of cholecystitis is even less frequent [ 6 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Pericholecystic fluid (halo) or subserosal edema, intramural gas or hydrops and the presence of echogenic bile have also been described. In uncertain cases, computed tomography and cholescintigraphy using 99mTc are reasonable imaging alternatives to establish the diagnosis [ 26 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Acalculous Cholecystitis Due to a Primary Epstein Barr Virus Infection in a Pediatric Patient

et al. 2021

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Epstein–Barr virus (EBV) is estimated to infect more than 98% of adults worldwide and is one of the most common human viruses. Acute acalculous cholecystitis (AAC) of the gallbladder is an atypical complication of infectious mononucleosis caused by EBV. Conservative management has been described in the context of AAC caused by EBV. A surgical approach must be considered in the case of acute complications such as perforation or gallbladder gangrene. We present the case of a 10-year-old female patient with AAC due to infectious mononucleosis syndrome caused by primary EBV infection.

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“…It should be mentioned that even when a cholecystectomy was performed, in situ hybridization of the tissue did not reveal the virus[ 35 ]. Moreover, Ntelis et al [ 36 ] speculated that vasculitis is the major underlying mechanism, but further investigation is required to support this hypothesis. Finally, compression of the cystic duct by an enlarged celiac lymph node could explain the development of AAC[ 30 ].…”

Section: Acalculous Cholecystitis In Patients Without Underlying Critical Illnessmentioning

confidence: 99%

Acute acalculous cholecystitis due to infectious causes

Markaki¹,

Konsoula²,

Markaki³

et al. 2021

WJCC

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Acute acalculous cholecystitis (AAC) is an inflammation of the gallbladder not associated with the presence of gallstones. It usually occurs in critically ill patients but it has also been implicated as a cause of cholecystitis in previously healthy individuals. In this subgroup of patients, infectious causes comprise the primary etiology. We, herein, discuss the pathophysiological mechanisms involved in AAC, focusing on the infectious causes. AAC associated with critical medical conditions is caused by bile stasis and gallbladder ischemia. Several mechanisms are reported to be involved in AAC in patients without underlying critical illness including direct invasion of the gallbladder epithelial cells, gallbladder vasculitis, obstruction of the biliary tree, and sequestration. We emphasize that multiple pathogenic mechanisms may concurrently contribute to the development of AAC in varying degrees. Awareness of the implicated pathogens is essential since it will allow a more focused examination of the histopathological specimens. In conclusion, additional research and a high degree of clinical suspicion are needed to clarify the complex spectrum of mechanisms that are involved in the pathogenesis of AAC.

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Acute Acalculous Cholecystitis Associated with Epstein–Barr Infection: A Case Report and Review of the Literature

Cited by 13 publications

References 49 publications

A Curious Case of Acute Acalculous Cholecystitis

A Curious Case of Acute Acalculous Cholecystitis

Acute Acalculous Cholecystitis Due to a Primary Epstein Barr Virus Infection in a Pediatric Patient

Acute acalculous cholecystitis due to infectious causes

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