Herpes zoster as a diagnostic pitfall leading to an unwarranted cholecystectomy: a case report

Some cases of herpes zoster infection present solely with abdominal pain in the early stage, potentially leading to misdiagnosis as cholecystitis and an unwarranted cholecystectomy. In August 2025, a 62-year-old female patient with a history of chronic cholecystitis presented with a 2-day history of right upper quadrant abdominal pain, without the characteristic vesicular rash. She was diagnosed with acute cholecystitis and underwent laparoscopic cholecystectomy. However, the subsequent development of clusters of vesicles on the right abdominal skin led to the diagnosis of herpes zoster. Herpes zoster infection can present with abdominal pain as its initial manifestation; this poses a formidable diagnostic challenge, potentially leading to misdiagnosis as acute cholecystitis and unwarranted cholecystectomy.