Acute cholecystitis associated with Clonorchis sinensis infection

Area of Science:

• Parasitology
• Gastroenterology
• Hepatology

Background:

• Clonorchis sinensis (C. sinensis) is a parasitic flatworm responsible for clonorchiasis, a significant public health concern in East Asia.
• Infection typically occurs through consuming raw or undercooked freshwater fish containing infective metacercarial cysts.
• Adult C. sinensis predominantly inhabit the intrahepatic bile ducts, potentially leading to inflammation, bile duct stones, and cholangiocarcinoma.

Observation:

• The case involves a patient presenting with primary acute cholecystitis, an inflammation of the gallbladder.
• Diagnostic investigations revealed the presence of Clonorchis sinensis within the biliary system, implicating the parasite as the direct cause.
• This presentation is highly unusual, as acute cholecystitis is not a commonly recognized complication of C. sinensis infection.

Findings:

• The study documents an extremely rare instance of acute cholecystitis directly attributed to Clonorchis sinensis infection.
• The findings highlight the potential for C. sinensis to cause unexpected clinical manifestations beyond its typical biliary tract pathology.
• Microscopic and macroscopic evidence confirmed the presence of adult flukes within the gallbladder and associated bile ducts.

Implications:

• This case expands the known spectrum of clinical presentations associated with C. sinensis.
• It underscores the importance of considering parasitic infections in the differential diagnosis of acute cholecystitis, especially in endemic areas.
• Further research may be warranted to understand the specific mechanisms linking C. sinensis to acute cholecystitis and its management.