O Measles-Associated Acute Acalculous Cholecystitis

Abstract

Background: Measles is a highly contagious viral infection whose complications most commonly involve the respiratory tract and the central nervous system. We report here what we think to be the first case of acute acalculous cholecystitis occurring during the course of measles. Case Presentation: A 22-year-old female presented with fever, sore throat, coryza and an erythematous maculopapular eruption. The diagnosis of measles was confirmed by the presence of IgM antibodies to measles virus in the absence of IgG antibodies. After initial favorable evolution, she developed abdominal pain with positive Murphy's sign and elevated liver enzymes. Ultrasonographic examination of the abdomen showed thickening (6.5 mm) of the gallbladder wall in the absence of stones or biliary tract dilatation. Evolution was spontaneously favorable, so that neither antibiotic therapy nor surgical intervention were necessary. Conclusion: In the context of worldwide recent measles outbreak, we think that clinicians should be aware of the possible occurrence of acute acalculous cholecystitis, a pathology usually associated with a high rate of complications.

Acute Acalculous Cholecystitis after Measles

“…Similarly to the other case, AAC occurred as a complication during the recovery period. 7 Measles-associated hepatobiliary complications have been classified into two patterns. The more common is hepatocellular dysfunction, which has been attributed to a viral cytopathic effect.…”

C-Reactive Protein: Pathophysiology, Diagnosis, False Test Results and a Novel Diagnostic Algorithm for Clinicians

“…Yet, it was previously reported that anti-CRP autoantibodies have been reported in hepatitis C cases, a fact that raises further diagnostic questions for its lower levels in that condition. Acute acalculous cholecystitis case reports reveal different CRP concentrations after different various pathogenic agents (about 5 mg/L for Epstein–Barr Virus (EBV), and more than 200 mg/L in measles infection and various other intermediate values due to other viruses) [ 941 , 942 , 943 , 944 , 945 , 946 , 947 , 948 , 949 ].…”