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Mycobacterium avium complex-associated cholecystitis in AIDS patient: a case description and review of literature

Firas El Chaer1, Nadine Harris1, Hana El Sahly1,2

  • 1Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.

International Journal of STD & AIDS
|May 30, 2015
PubMed

Insights

Mycobacterium avium complex (MAC) can cause acute cholecystitis in patients with AIDS-related cholangiopathy. This opportunistic infection highlights the need for considering MAC in advanced AIDS patients with gallbladder inflammation.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Gastroenterology

Background:

  • AIDS-related cholangiopathy was prevalent before effective antiretroviral therapy.
  • Mycobacterium avium complex (MAC) is a common opportunistic infection in AIDS patients and a potential cause of cholangiopathy.

Observation:

  • A case of acute cholecystitis secondary to MAC in a patient with likely AIDS cholangiopathy is presented.
  • The patient, a 37-year-old woman with severe immunosuppression (CD4 count of 10 cells/mm³), had a history of disseminated MAC.

Findings:

  • Radiologic imaging indicated acute cholecystitis, leading to cholecystectomy.
  • Gallbladder pathology confirmed acid-fast bacilli consistent with MAC infection.
  • Despite outpatient MAC therapy, severe immunosuppression likely contributed to the high disease burden.

Implications:

  • Acute cholecystitis can occur as a complication of AIDS cholangiopathy, potentially due to the underlying opportunistic infection.
  • MAC-related gallbladder disease should be considered in advanced AIDS patients presenting with acute cholecystitis.
  • This case underscores the importance of considering opportunistic infections in the differential diagnosis of gallbladder disease in immunocompromised individuals.
Keywords:
AIDS cholangiopathyHIV/AIDSMycobacterium avium complex cholecystitis

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