Acute acalculous cholecystitis in dengue fever: a case series

Dengue fever is the most important arbovirus illness with an estimated incidence of 50–100 million cases per year. The common symptoms of dengue include fever, rash, malaise, nausea, vomiting, and musculoskeletal pain. Dengue fever may present as acute abdomen leading to diagnostic dilemma. The acute surgical complications of dengue fever include acute pancreatitis, acute acalculous cholecystitis, nonspecific peritonitis, and acute appendicitis. We report a case of dengue fever that mimicked acute appendicitis leading to unnecessary appendectomy. A careful history examination for dengue-related signs, and serial hemogram over the first 3-4 days of disease may prevent unnecessary appendectomy.

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Acute Acalculous Cholecystitis in Dengue Fever: An Alert for Emergency Surgeons

Panamerican Journal of Trauma, Critical Care & Emergency Surgery ◽

10.5005/jp-journals-10030-1180 ◽

2017 ◽

Vol 6 (2) ◽

pp. 124-126

Author(s):

Fernando Spencer Netto ◽

Julia R Scherer ◽

Carla S de Oliveira

Keyword(s):

Dengue Fever ◽

Acalculous Cholecystitis ◽

Viral Disease ◽

Tertiary Hospital ◽

Nonoperative Treatment ◽

Initial Assessment ◽

Severe Dengue ◽

Acute Acalculous Cholecystitis ◽

Abdominal Symptoms ◽

Atypical Presentations

ABSTRACT Dengue fever is an acute viral disease, typical of tropical countries and endemic in Brazil, which can present abdominal symptoms and complications. One of its atypical presentations is acute acalculous cholecystitis (AAC), present in 6% of the severe cases. It is usually self-limited, and generally improves with nonoperative treatment. This is a case report of a patient transferred to a tertiary hospital for surgical evaluation of acute abdomen. She presented with significant abdominal findings (pain, nausea, and vomits), suggestive of acute cholecystitis. After initial assessment and examinations, the patient was diagnosed with severe dengue fever and AAC. The patient was treated conservatively and improved within 3 days. Physicians must be aware of ACC in patients with suspicious presentations in endemic areas for dengue fever. Surgery should be avoided once it is associated with significant postoperative complications and death. How to cite this article Becker MJ, Scherer JR, de Oliveira CS, Netto FS. Acute Acalculous Cholecystitis in Dengue Fever: An Alert for Emergency Surgeons. Panam J Trauma Crit Care Emerg Surg 2017;6(2):124-126.

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Acute acalculous cholecystitis in dengue fever patients

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20170923 ◽

2017 ◽

Vol 4 (2) ◽

pp. 375 ◽

Cited By ~ 2

Author(s):

Manish Chandey ◽

Harjot Kaur ◽

Sukhjeet Kaur

Keyword(s):

Pleural Effusion ◽

Dengue Fever ◽

Joint Pain ◽

Febrile Illness ◽

Acalculous Cholecystitis ◽

Acute Acalculous Cholecystitis ◽

Acute Febrile Illness ◽

Ocular Pain ◽

Diagnostic Significance

Background: Dengue fever is an acute febrile illness characterized by frontal headache, retro ocular pain, muscle and joint pain, nausea, vomiting and rash. Frequent sonographic findings in a case of dengue include thickened gall bladder with pericholecystitic fluid, ascites, spleenomegaly and pleural effusion which is commonly right sided.Methods: 540 patients of confirmed dengue fever were subjected to ultrasonography abdomen to find the incidence of acalculous cholecystitis for diagnostic and prognostic significance.Results: Acalculous cholecystitis was detected in 210 patients (38.88%) of confirmed dengue fever. Patients developing acalculous cholecystitis recovered with conservative treatment only though the hospital stay was prolonged in these patients.Conclusions: In dengue fever patients, acute acalculous cholecystitis is not uncommon and is usually self-limiting and resolves with conservative management only. Role of ultrasonography has a supporting role in dengue fever for prognostic and diagnostic significance.

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Gallbladder perforation in acute acalculous cholecystitis: an atypical manifestation of dengue fever

International Surgery Journal ◽

10.18203/2349-2902.isj20181614 ◽

2018 ◽

Vol 5 (5) ◽

pp. 1943 ◽

Cited By ~ 1

Author(s):

Nikhil Deshmukh ◽

Alok Rath ◽

Sridhar Reddy M. ◽

Naresh M.

Keyword(s):

Gall Bladder ◽

Dengue Fever ◽

Acalculous Cholecystitis ◽

Bladder Perforation ◽

Wound Complications ◽

Gallbladder Perforation ◽

Acute Acalculous Cholecystitis ◽

Small Subset ◽

Early Recovery ◽

Laparoscopic Management

Among the atypical manifestations of dengue fever, comprising 15.8% of all cases, acalculous cholecystitis forms a small subset. Acalculous cholecystitis is managed conservatively in majority of cases and a chance of gall bladder perforation is low (2-18%). Management of gall bladder perforation in the scenario of Dengue is sometimes complicated by presence of thrombocytopenia and its complications thereof. Mortality associated with gall bladder perforation is relatively high. Gallbladder usually perforates at the fundus and is to be dealt with surgically if it doesn’t localize. Laparoscopic management of gall bladder perforation is feasible as calot’s is relatively virgin (as there is no calculous disease). Thorough peritoneal toileting is possible and a chance of intra-abdominal abscess in post-operative period is a mere speculation. Laparoscopic management results in early recovery and fewer wound complications and lesser hospital stay.

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Acute Acalculous Cholecystitis Due to a Primary Epstein Barr Virus Infection in a Pediatric Patient

Pediatric Reports ◽

10.3390/pediatric13010011 ◽

2021 ◽

Vol 13 (1) ◽

pp. 86-90

Author(s):

Carlos Leganés Villanueva ◽

Ilaria Goruppi ◽

Nuria Brun Lozano ◽

Federica Bianchi ◽

María Quinteiro González ◽

...

Keyword(s):

Infectious Mononucleosis ◽

Epstein Barr Virus ◽

Acalculous Cholecystitis ◽

Acute Acalculous Cholecystitis ◽

Epstein Barr Virus Infection ◽

Barr Virus ◽

Acute Complications ◽

Epstein Barr ◽

Barr Virus Infection ◽

Human Viruses

Epstein–Barr virus (EBV) is estimated to infect more than 98% of adults worldwide and is one of the most common human viruses. Acute acalculous cholecystitis (AAC) of the gallbladder is an atypical complication of infectious mononucleosis caused by EBV. Conservative management has been described in the context of AAC caused by EBV. A surgical approach must be considered in the case of acute complications such as perforation or gallbladder gangrene. We present the case of a 10-year-old female patient with AAC due to infectious mononucleosis syndrome caused by primary EBV infection.

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