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Acute acalculous cholecystitis in leptospirosis
R K Vilaichone1, V Mahachai, H Wilde
1Department of Medicine, Chulalongkorn University Hospital, Bangkok, Thailand.
Journal of Clinical Gastroenterology
|October 6, 1999
Summary
Leptospirosis can mimic acalculous cholecystitis, causing right upper quadrant pain. Early diagnosis through awareness and lab tests can prevent unnecessary surgery for this systemic disease.
Area of Science:
- Infectious Diseases
- Gastroenterology
Background:
- Acalculous cholecystitis presents as right upper quadrant pain, often requiring surgical evaluation.
- Leptospirosis is a bacterial infection with diverse clinical manifestations.
Observation:
- Three patients presented with symptoms suggestive of acalculous cholecystitis at a tertiary care center.
- One patient underwent surgery due to suspected peritonitis; two were managed conservatively with antibiotics.
Findings:
- Leptospirosis was confirmed in all three patients via serological tests and blood culture.
- Leptospira were not identified in the surgical specimen, suggesting the gallbladder was not the primary site of infection.
- The clinical presentation mimicked cholecystitis, highlighting a diagnostic challenge.
Implications:
- Leptospirosis should be considered in the differential diagnosis of patients with right upper quadrant pain.
- Increased physician awareness and targeted laboratory investigations are crucial for accurate diagnosis.
- Timely diagnosis of leptospirosis can prevent unnecessary surgical interventions for presumed cholecystitis.