Delayed Post-cholecystectomy Gallbladder Fossa Abscess Due to Citrobacter freundii

Area of Science:

• Gastroenterology
• Infectious Diseases
• Surgical Complications

Background:

• Laparoscopic cholecystectomy is the standard treatment for cholecystitis.
• Complications like abscess formation can arise years post-surgery.
• Gallbladder fossa abscesses are uncommon but serious post-cholecystectomy complications.

Observation:

• A patient with a remote history of laparoscopic cholecystectomy presented with a gallbladder fossa abscess.
• The abscess was infected with *Citrobacter freundii*, a bacterium not typically associated with this type of infection.
• The patient had no recent events or risk factors for abdominal wall abscess.

Findings:

• Percutaneous drainage and prolonged antibiotic therapy led to clinical and radiological improvement.
• *Citrobacter freundii* can cause rare, late-onset abscesses following cholecystectomy.
• Low-virulence pathogens can cause significant infections with long latency periods.

Implications:

• A remote surgical history, particularly cholecystectomy, should be considered in diagnosing unexplained abscesses.
• The possibility of rare pathogens like *Citrobacter* in late-onset surgical site infections warrants consideration.
• This case underscores the importance of a comprehensive patient history in identifying the etiology of complex infections.