scholarly journals Acalculous Cholecystitis in a Young Adult with Scrub Typhus: A Case Report and Epidemiology of Scrub Typhus in the Maldives

2021 ◽  
Vol 6 (4) ◽  
pp. 208
Author(s):  
Hisham Ahmed Imad ◽  
Aishath Azna Ali ◽  
Mariyam Nahuza ◽  
Rajan Gurung ◽  
Abdulla Ubaid ◽  
...  
Keyword(s):  
Epstein Barr Virus ◽  
Scrub Typhus ◽  
Human Herpesvirus ◽  
Febrile Illness ◽  
Acalculous Cholecystitis ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Acute Acalculous Cholecystitis ◽  
Barr Virus ◽  
Epstein Barr ◽  
Herpesvirus 4

Scrub typhus is a neglected tropical disease predominantly occurring in Asia. The causative agent is a bacterium transmitted by the larval stage of mites found in rural vegetation in endemic regions. Cases of scrub typhus frequently present as acute undifferentiated febrile illness, and without early diagnosis and treatment, the disease can develop fatal complications. We retrospectively reviewed de-identified data from a 23-year-old woman who presented to an emergency department with complaints of worsening abdominal pain. On presentation, she appeared jaundiced and toxic-looking. Other positive findings on abdominal examination were a positive Murphey’s sign, abdominal guarding and hepatosplenomegaly. Magnetic resonance cholangiopancreatography demonstrated acalculous cholecystitis. Additional findings included eschar on the medial aspect of the left thigh with inguinal regional lymphadenopathy. Further, positive results were obtained for immunoglobulins M and G, confirming scrub typhus. The workup for other infectious causes of acute acalculous cholecystitis (AAC) detected antibodies against human herpesvirus 4 (Epstein–Barr virus), suggesting an alternative cause of AAC. Whether that represented re-activation of the Epstein–Barr virus could not be determined. As other reports have described acute acalculous cholecystitis in adult scrub typhus patients, we recommend doxycycline to treat acute acalculous cholecystitis in endemic regions while awaiting serological confirmation.

scholarly journals Orientia tsutsugamushi and Epstein-Barr Virus in a Young Adult with Acalculous Cholecystitis: A Case Report and Epidemiology of Scrub Typhus in the Maldives

2021 ◽  
Author(s):  
Hisham Ahmed Imad ◽  
Aishath Azna Ali ◽  
Mariyam Nahuza ◽  
Rajan Gurung ◽  
Abdulla Ubaid ◽  
...  
Keyword(s):  
Epstein Barr Virus ◽  
Scrub Typhus ◽  
Acute Infection ◽  
Human Herpesvirus ◽  
Febrile Illness ◽  
Acalculous Cholecystitis ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Acute Acalculous Cholecystitis ◽  
Barr Virus ◽  
Epstein Barr

Scrub typhus is a neglected tropical disease predominantly occurring in Asia. The causative agent is a bacterium transmitted by the larval stage of mites found in rural vegetation in endemic regions. Cases of scrub typhus frequently present as acute undifferentiated febrile illness, and without early diagnosis and treatment, the disease can develop fatal complications. We retrospectively reviewed de-identified data from a 23-year-old woman who presented to an emergency department with complaints of worsening abdominal pain. On presentation, she appeared jaundiced and toxic-looking. Other positive findings on abdominal examination were a positive Murphey’s sign, abdominal guarding and hepatosplenomegaly. Magnetic resonance cholangiopancreatography demonstrated acalculous cholecystitis. Additional findings included eschar on the medial aspect of the left thigh with inguinal regional lymphadenopathy. Further, positive results were obtained for immunoglobulins M and G, confirming scrub typhus. Workups for other infectious causes of acute acalculous cholecystitis detected human herpesvirus 4 (Epstein-Barr virus). Whether that represented acute infection or re-activation of the Epstein-Barr virus could not be determined. As other reports have described acute acalculous cholecystitis in adult scrub typhus patients, we recommend doxycycline to treat acute acalculous cholecystitis in endemic regions while awaiting serological confirmation.

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

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.

scholarly journals Acute Acalculous Cholecystitis: A Rare Presentation of Primary Epstein-Barr Virus Infection in Adults—Case Report and Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Zuhal Yesilbag ◽  
Asli Karadeniz ◽  
Fatih Oner Kaya
Keyword(s):  
Epstein Barr Virus ◽  
Conservative Therapy ◽  
Gastrointestinal Symptoms ◽  
Acalculous Cholecystitis ◽  
Acute Acalculous Cholecystitis ◽  
Epstein Barr Virus Infection ◽  
Rare Presentation ◽  
Barr Virus ◽  
Ebv Infection ◽  
Epstein Barr

Primary Epstein-Barr virus (EBV) infection is almost always a self-limited disease characterized by sore throat, fever, and lymphadenopathy. Hepatic involvement is usually characterized by mild elevations of aminotransferases and resolves spontaneously. Although isolated gallbladder wall thickness has been reported in these patients, acute acalculous cholecystitis is an atypical presentation of primary EBV infection. We presented a young women admitted with a 10-day history of fever, nausea, malaise who had jaundice and right upper quadrant tenderness on the physical examination. Based on diagnostic laboratory tests and abdominal ultrasonographic findings, cholestasis and acute acalculous cholecystitis were diagnosed. Serology performed for EBV revealed the acute EBV infection. Symptoms and clinical course gradually improved with the conservative therapy, and at the 1-month follow-up laboratory findings were normal. We reviewed 16 adult cases with EBV-associated AAC in the literature. Classic symptoms of EBV infection were not predominant and all cases experienced gastrointestinal symptoms. Only one patient underwent surgery and all other patients recovered with conservative therapy. The development of AAC should be kept in mind in patients with cholestatic hepatitis due to EBV infection to avoid unnecessary surgical therapy and overuse of antibiotics.

scholarly journals Acute Acalculous Cholecystitis Associated with Epstein–Barr Infection: A Case Report and Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Konstantinos Ntelis ◽  
Dimosthenis Mazarakis ◽  
Apostolos Sapountzis ◽  
Dimitra Zissi ◽  
Sophia Sparangi ◽  
...  
Keyword(s):  
Epstein Barr Virus ◽  
Rare Complication ◽  
Relevant Literature ◽  
Young Patients ◽  
Acalculous Cholecystitis ◽  
Acute Acalculous Cholecystitis ◽  
Barr Virus ◽  
Ebv Infection ◽  
Rare Manifestation ◽  
Epstein Barr

The most common cause of acute cholecystitis (ACC) is cholelithiasis. Acute acalculous cholecystitis (AAC) is well documented in the literature related with critical illness, but viral causes such as cytomegalovirus (CMV) and Epstein–Barr virus (EBV) have also been reported. We present a rare manifestation of EBV infection, reporting a case of a 15-year-old female suffering from acute acalulous cholecystitis, and we review the relevant literature. Clinicians should be aware of this rare complication of EBV infection and properly exclude it in young patients with cholecystitis.

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