Brucellosis, an uncommon cause of acute acalculous cholecystitis: two new cases and concise review

Acalculous cholecystitis etiologies while numerous, some of them are less-known such as brucellosis. In this report, we elaborate the clinical findings, investigations and management of two female patients presenting acalculous cholecystitis in whom diagnosis of acute brucellosis was retained. Both...

Full description

Saved in:
Bibliographic Details
Published in:BMJ case reports 2019-09, Vol.12 (9), p.e229616
Main Authors: Hariz, Anis, Beji, Imen, Hamdi, Mohamed Salah, Cherif, Eya
Format: Article
Language:English
Subjects:
Abdomen
Abdominal Pain - microbiology
Acalculous Cholecystitis - diagnostic imaging
Acalculous Cholecystitis - drug therapy
Acalculous Cholecystitis - microbiology
Acute Disease
Animals
Anti-Bacterial Agents - therapeutic use
Antibiotics
Blood
Brucellosis
Brucellosis - complications
Brucellosis - diagnostic imaging
Brucellosis - drug therapy
Brucellosis - physiopathology
C-Reactive Protein - metabolism
Case reports
Cholecystectomy
Dairy products
Doxycycline - therapeutic use
Family medical history
Female
Fever
Food Contamination
Gallbladder
Gallbladder diseases
Hemoglobin
Hepatitis
Humans
Infections
Inflammation
Internal medicine
Laboratories
Medical diagnosis
Middle Aged
Milk - microbiology
Raw Foods - adverse effects
Rifampin - therapeutic use
Treatment Outcome
Ultrasonic imaging
Ultrasonography
Unusual Presentation of More Common Disease/Injury
Vomiting
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Acalculous cholecystitis etiologies while numerous, some of them are less-known such as brucellosis. In this report, we elaborate the clinical findings, investigations and management of two female patients presenting acalculous cholecystitis in whom diagnosis of acute brucellosis was retained. Both patients had fever, asthenia and abdominal tenderness. Laboratory results showed evidence of inflammation as well as hepatic cytolysis while cholestasis was noted in one patient. In both cases, ultrasound study and CT confirmed the presence of acalculous cholecystitis. Serology (tube agglutination test) led to the diagnosis of brucellosis. Diagnosis of brucellosis-related acute cholecystitis was established in both cases based on imaging findings as well as serology without resorting to cholecystectomy. Favourable clinical response to specific antibiotic therapy further supported our diagnosis as well as our decision to avoid surgery. Although few cases have been reported, brucellosis must be considered as a cause of acalculous cholecystitis, especially in endemic countries.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2019-229616