Helicobacter bilis-Associated Suppurative Cholangitis in a Patient with X-Linked Agammaglobulinemia

Abstract OBJECTIVE To characterize clinical features, comorbidities, frequency of bacterial isolation, and survival time in cats with suppurative cholangitis-cholangiohepatitis syndrome (S-CCHS). ANIMALS 168 client-owned cats with S-CCHS. PROCEDURES Data were prospectively (1980 to 2019) collected regarding clinical features, comorbidities, bacterial infection, illness duration, and treatments. Variables were evaluated for associations with survival time. RESULTS Median age of cats was 10.0 years, with no breed or sex predilection observed. Common clinical features included hyporexia (82%), hyperbilirubinemia (80%), lethargy (80%), vomiting (80%), jaundice (67%), weight loss (54%), and hypoalbuminemia (50%). Comorbidities included extrahepatic bile duct obstruction (53%), cholelithiasis (42%), cholecystitis (40%), and ductal plate malformation (44%) as well as biopsy-confirmed inflammatory bowel disease (60/68 [88%]) and pancreatitis (41/44 [93%]). Bacterial cultures were commonly positive (69%) despite prebiopsy antimicrobial administration in most cats. Of surgically confirmed choleliths, diagnostic imaging identified only 58%. Among 55 cats with “idiopathic pancreatitis,” 28 (51%) were documented to have transiting choleliths, and 20 had pancreatic biopsies confirming pancreatitis. Cholelithiasis (with or without bile duct obstruction) and cholecystectomy were associated with survival advantages. Survival disadvantages were found for leukocytosis, ≥ 2-fold increased alkaline phosphatase, and hyperbilirubinemia. Cholecystoenterostomy had no survival impact. Cats with ductal plate malformations were significantly younger at diagnosis and death than other cats. Chronic treatments with antimicrobials, S-adenosylmethionine, and ursodeoxycholic acid were common postbiopsy. CLINICAL RELEVANCE S-CCHS in cats was associated with bacterial infection and various comorbidities and may be confused with pancreatitis. Surgically correctable morbidities (ie, cholecystitis, cholecystocholelithiasis) and cholecystectomy provided a significant survival advantage.

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SUPPURATIVE CHOLANGITIS; PANCREATITIS; HEPATIC DRAINAGE

Annals of Surgery ◽

10.1097/00000658-191009000-00009 ◽

1910 ◽

Vol 52 (3) ◽

pp. 425 ◽

Cited By ~ 1

Author(s):

&NA;

Keyword(s):

Suppurative Cholangitis

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Case of acute onset ataxia caused by Klebsiella pneumoniae sepsis with the appearance of anti-GD1b antibody

BMJ Case Reports ◽

10.1136/bcr-2021-242396 ◽

2021 ◽

Vol 14 (8) ◽

pp. e242396

Author(s):

Shigeo Yamada ◽

Takashi Umeya

Keyword(s):

Klebsiella Pneumoniae ◽

Polymyxin B ◽

Endotoxin Shock ◽

Acute Onset ◽

Serum Samples ◽

Igg Antibody ◽

Fisher Syndrome ◽

Truncal Ataxia ◽

Genetic Features ◽

Suppurative Cholangitis

Various disorders can cause acute onset ataxia including those that have toxic/metabolic, traumatic, neoplastic, vascular, demyelinating/dysmyelinating, infectious, postinfectious and genetic features. We present a case of postseptic acute ataxia. A 72-year-old woman was diagnosed with septic shock secondary to acute obstructive suppurative cholangitis. A blood sample for bacterial culture was positive for Klebsiella pneumoniae. Thus, we initiated antibiotics and intravenous immunoglobulin therapies to control the infection. We later added extracorporeal endotoxin removal with a polymyxin B immobilised fibre cartridge for endotoxin shock. The patient’s condition improved soon after endotoxin removal. Mildly slurred and explosive speech with limb and truncal ataxia, which improved gradually, developed shortly afterwards. Serum samples obtained on day 15 after admission were positive for anti-GD1b IgG antibody. The clinical course of monophasic illness with good recovery, neurological findings and the appearance of anti-GD1b antibody suggest that this case is a variant of Miller-Fisher syndrome.

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Chronic Non Suppurative Cholangitis

Encyclopedia of Molecular Mechanisms of Disease ◽

10.1007/978-3-540-29676-8_7960 ◽

2009 ◽

pp. 357-358

Author(s):

Nils Peters ◽

Martin Dichgans ◽

Sankar Surendran ◽

Josep M. Argilés ◽

Francisco J. López-Soriano ◽

...

Keyword(s):

Suppurative Cholangitis

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Morbidity and Mortality in the Koala (Phascolarctos cinereus).

Australian Journal of Zoology ◽

10.1071/zo9610024 ◽

1961 ◽

Vol 9 (1) ◽

pp. 24 ◽

Cited By ~ 34

Author(s):

TC Backhouse ◽

A Bolliger

Keyword(s):

Ulcerative Colitis ◽

Cause Of Death ◽

Middle Ear ◽

Cardiac Failure ◽

Unknown Origin ◽

Primary Lesion ◽

Blood Dyscrasia ◽

Cystic Disease ◽

Phascolarctos Cinereus ◽

Suppurative Cholangitis

In all, 28 koalas (Phascolarctos cinereus), 26 of which had died exclusively of natural causes, were autopsied and in 21 of these a probable cause of death could be recognized. Different forms of pneumonia head the list of these causes with six cases, including two where the primary lesion was trauma. Hepatitis with suppurative cholangitis was observed in three instances. Cryptococcosis, an infection by the yeast Cryptococcus neoformans, was responsible for three deaths, and two forms of blood dyscrasia, i.e. lymphoblastic leukaemia, and an anaemia of unknown origin accounted for two more deaths. Cystic disease of the ovary was observed in six koalas, and in four cases was complicated by infection and was the main cause of death. Middle ear sepsis, ulcerative colitis, and cardiac failure associated with senility were seen once each. In the remaining seven cases the cause of death was indeterminate, though senility appeared to be the predisposing cause in two.

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