A case of acute acalculous cholecystitis complicated by primary Epstein-Barr virus infection

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Kenichi Suga1, Miki Shono, Aya Goji

  • 1Department of Pediatrics, Tokushima Prefectural Central Hospital.

The Journal of Medical Investigation : JMI
|September 30, 2014
PubMed

Insights

Acute acalculous cholecystitis (AAC), a rare complication of infectious mononucleosis (IM), can occur in children. Early diagnosis via ultrasound is crucial for prompt, conservative treatment and full recovery.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Gastroenterology

Background:

  • Infectious mononucleosis (IM), caused by Epstein-Barr virus (EBV), is common in children.
  • Acute acalculous cholecystitis (AAC) is an uncommon but serious complication.
  • AAC typically lacks gallstones and presents with gallbladder inflammation.

Observation:

  • A 6-year-old immunocompetent girl with IM presented with epigastric pain.
  • Abdominal ultrasonography showed a thickened, sonolucent gallbladder wall without gallstones.
  • Primary EBV infection was confirmed; a false-positive CMV IgM was noted.

Findings:

  • The patient was diagnosed with AAC secondary to primary EBV infection.
  • Conservative management led to complete clinical recovery.
  • This case highlights a rare association between IM and AAC.

Implications:

  • Healthcare providers should consider AAC in IM patients with abdominal pain.
  • Ultrasonography is a key diagnostic tool for suspected AAC in this context.
  • Prompt diagnosis and conservative treatment can lead to favorable outcomes in pediatric AAC associated with IM.

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