Acute acalculous cholecystitis due toSalmonella

Garrido-Benedicto, P.; González‐Reimers, Emilio; Santolaria-Fernández, Francisco; Rodríguez-Moreno, F.

doi:10.1007/bf02090223

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…The Nramp1-defective nature of the animal model that we used does not allow for the study of chronic salmonellosis, because most animals succumb to the infection. However, our results help explain gallbladder pathogenesis in the context of acute typhoid fever; the gallbladder histopathology that we observed recapitulates the damage described in sonographic studies of gallbladder in acute human typhoid fever (thickened and inflamed gallbladder wall, biliary sludge, mucosal irregularity with sloughed membrane, and the presence of inflammatory cell infiltrate [7,8,10,11,13,14,39]). Thus, our results strongly suggest that intracellular infection of gallbladder epithelial cells also occurs in human typhoid fever.…”

Section: Discussionsupporting

confidence: 80%

“…Gallbladder infections are common in typhoid fever; Salmonella have been isolated from gallbladders from patients with acute and chronic disease [1][2][3][4][5][6][7][8]. In acute typhoid fever, colonization of the gallbladder is rarely diagnosed, but it may become apparent with the onset of acalculous cholecystitis [7,[9][10][11] and gallbladder perforation [7,8,12].…”

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confidence: 99%

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SalmonellaInfection of Gallbladder Epithelial Cells Drives Local Inflammation and Injury in a Model of Acute Typhoid Fever

Menéndez¹,

Arena²,

Guttman³

et al. 2009

J INFECT DIS

134

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The gallbladder is often colonized by Salmonella during typhoid fever, yet little is known about bacterial pathogenesis in this organ. With use of a mouse model of acute typhoid fever, we demonstrate that Salmonella infect gallbladder epithelial cells in vivo. Bacteria in the gallbladder showed a unique behavior as they replicated within gallbladder epithelial cells and remained confined to those cells without translocating to the mucosa. Infected gallbladders showed histopathological damage characterized by destruction of the epithelium and massive infiltration of neutrophils, accompanied by a local increase of proinflammatory cytokines. Damage was determined by the ability of Salmonella to invade gallbladder epithelial cells and was independent of high numbers of replication-competent, although invasion-deficient, bacteria in the lumen. Our results establish gallbladder epithelial cells as a novel niche for in vivo replication of Salmonella and reveal the involvement of these cells in the pathogenesis of Salmonella in the gallbladder during the course of acute typhoid fever.

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Section: Discussionsupporting

confidence: 80%

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confidence: 99%

SalmonellaInfection of Gallbladder Epithelial Cells Drives Local Inflammation and Injury in a Model of Acute Typhoid Fever

Menéndez¹,

Arena²,

Guttman³

et al. 2009

J INFECT DIS

134

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“…AAC due to primary bacterial infection is rare. Several cases have been reported complicating Salmonella typhi infection [3,6] and after non-typhoidal salmonellosis [7,8] as well. During the past two decades, an increase in the number of Salmonella enteritidis isolates has been observed even in developed countries [9] , and there are also rare complications of this common disease described in medical literature [10] Some of these complications are extra-intestinal such as septic arthritis [11] or meningitis [12] , but most of them are intra-abdominal [13] due to blood or lymphatic spread of the gbacteria.…”

Section: Discussionmentioning

confidence: 99%

Acalculous cholecystitis due to Salmonella enteritidis

Ruiz-Rebollo

Sánchez-Antolín²,

García-Pajares³

et al. 2008

WJG

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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.

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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 due toSalmonella

Cited by 3 publications

References 6 publications

SalmonellaInfection of Gallbladder Epithelial Cells Drives Local Inflammation and Injury in a Model of Acute Typhoid Fever

SalmonellaInfection of Gallbladder Epithelial Cells Drives Local Inflammation and Injury in a Model of Acute Typhoid Fever

Acalculous cholecystitis due to Salmonella enteritidis

Acute acalculous cholecystitis due to infectious causes

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