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Staphylococcal acalculous cholecystitis in a child

Vandana Batra1, Jocelyn Y Ang, Basim I Asmar

  • 1Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, USA.

Southern Medical Journal
|March 13, 2003
PubMed

Insights

Acute acalculous cholecystitis, rare in children, presented in a 12-year-old with Staphylococcus aureus bacteremia. Antibiotic therapy alone proved effective, highlighting the potential for medical management over surgery.

Area of Science:

  • Pediatric Gastroenterology
  • Infectious Diseases
  • Skeletal System Infections

Background:

  • Acute acalculous cholecystitis (AACC) is gallbladder inflammation without stones, typically seen in critically ill adults.
  • AACC is uncommon in pediatric patients, posing diagnostic challenges.
  • Staphylococcus aureus bacteremia can lead to severe systemic infections.

Observation:

  • A 12-year-old boy presented with fever, jaundice, and abdominal pain.
  • The patient was diagnosed with AACC, sacroiliitis, and pelvic osteomyelitis.
  • Blood cultures confirmed Staphylococcus aureus bacteremia.

Findings:

  • Successful treatment of AACC, sacroiliitis, and osteomyelitis was achieved with antibiotic therapy alone.
  • Surgical intervention (cholecystectomy) was not required.
  • The patient's recovery demonstrated the efficacy of medical management in this complex pediatric case.

Implications:

  • A high index of suspicion is crucial for early diagnosis of AACC in children.
  • Medical management with antibiotics can be a viable alternative to surgery for AACC in select pediatric cases.
  • This case broadens the understanding of AACC presentation and treatment in the pediatric population.

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