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[Acalculous cholecystitis: an uncommon form of presentation of Q fever].
Gastroenterol Hepatol. 2005 Apr; 28(4):232-6.GH

Abstract

Acute acalculous cholecystitis is a very rare clinical presentation of Q fever. We report the case of a 38-year-old man who presented with fever associated with elevation of liver enzyme levels and thickening of the gallbladder wall on abdominal ultrasonography and who was initially diagnosed with acute acalculous cholecystitis. Due to the persistence of fever and transaminase elevation despite antibiotic treatment, a liver biopsy was performed. Characteristic "doughnut" epithelioid granulomas were observed, suggesting a diagnosis of granulomatous hepatitis caused by Q fever, which was confirmed by serological methods. Treatment with doxycycline was commenced and the patient subsequently showed rapid clinical improvement, with disappearance of fever and normalization of liver enzyme levels. We review 8 cases of acute cholecystitis associated with Q fever published in the literature and stress the importance of liver biopsy in the etiological diagnosis of patients with prolonged fever and abnormal liver function tests.

Authors+Show Affiliations

Sección de Aparato Digestivo, Hospital San Jorge, Huesca, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

spa

PubMed ID

15811266

Citation

González Delgado, L, et al. "[Acalculous Cholecystitis: an Uncommon Form of Presentation of Q Fever]." Gastroenterologia Y Hepatologia, vol. 28, no. 4, 2005, pp. 232-6.
González Delgado L, López Larramona G, Santolaria Piedrafita S, et al. [Acalculous cholecystitis: an uncommon form of presentation of Q fever]. Gastroenterol Hepatol. 2005;28(4):232-6.
González Delgado, L., López Larramona, G., Santolaria Piedrafita, S., García Prats, D., Ferrero Cáncer, M., & Montoro Huguet, M. (2005). [Acalculous cholecystitis: an uncommon form of presentation of Q fever]. Gastroenterologia Y Hepatologia, 28(4), 232-6.
González Delgado L, et al. [Acalculous Cholecystitis: an Uncommon Form of Presentation of Q Fever]. Gastroenterol Hepatol. 2005;28(4):232-6. PubMed PMID: 15811266.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Acalculous cholecystitis: an uncommon form of presentation of Q fever]. AU - González Delgado,L, AU - López Larramona,G, AU - Santolaria Piedrafita,S, AU - García Prats,D, AU - Ferrero Cáncer,M, AU - Montoro Huguet,M, PY - 2005/4/7/pubmed PY - 2005/5/27/medline PY - 2005/4/7/entrez SP - 232 EP - 6 JF - Gastroenterologia y hepatologia JO - Gastroenterol Hepatol VL - 28 IS - 4 N2 - Acute acalculous cholecystitis is a very rare clinical presentation of Q fever. We report the case of a 38-year-old man who presented with fever associated with elevation of liver enzyme levels and thickening of the gallbladder wall on abdominal ultrasonography and who was initially diagnosed with acute acalculous cholecystitis. Due to the persistence of fever and transaminase elevation despite antibiotic treatment, a liver biopsy was performed. Characteristic "doughnut" epithelioid granulomas were observed, suggesting a diagnosis of granulomatous hepatitis caused by Q fever, which was confirmed by serological methods. Treatment with doxycycline was commenced and the patient subsequently showed rapid clinical improvement, with disappearance of fever and normalization of liver enzyme levels. We review 8 cases of acute cholecystitis associated with Q fever published in the literature and stress the importance of liver biopsy in the etiological diagnosis of patients with prolonged fever and abnormal liver function tests. SN - 0210-5705 UR - https://www.unboundmedicine.com/medline/citation/15811266/[Acalculous_cholecystitis:_an_uncommon_form_of_presentation_of_Q_fever]_ L2 - http://www.elsevier.es/en/linksolver/ft/ivp/0210-5705/28/232 DB - PRIME DP - Unbound Medicine ER -