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Acute acalculous cholecystitis in dengue fever.
J Pak Med Assoc. 2009 Aug; 59(8):519-21.JP

Abstract

OBJECTIVE

To investigate the frequency, clinical features, management and outcome of acute acalculous cholecystitis in dengue fever patients.

METHODS

Forty patients were admitted with the diagnosis of dengue fever, according to the clinical manifestations and laboratory investigations. The diagnosis of dengue fever was confirmed by a positive IgM antibody test result for a late or convalescent phase blood specimen. The diagnosis of acute acalculous cholecystitis was made according to clinical features and sonographic findings. Liver function tests, complete blood counts were determined. Abdominal ultrasound was performed with a real time scanner in patients with abdominal pain and abnormal results on liver function tests.

RESULTS

Eleven out of 40 patients of dengue fever (27.5%) had complication of acute acalculous cholecystitis. There were 8 males and 3 females. The mean and standard deviation from the onset of fever to hospital visit was 3.3 +/- 0.8 days (range 2-5 days). The mean white cell counts was 4154 +/- 1577.5 cmm. The mean platelet counts were 26,727 +/- 10460.3 cmm on presentation in hospital. The mean SGPT level was 148.5 +/- 190.17 mg/dl. Mean alkaline phosphatase was 398 +/- 214.8 mg/dl. On sonography all had thickened gall bladder. The mean gall bladder wall thickness was 5.2 +/- 1.3 mm. Three patients had ascites and one patient had pleural effusion.

CONCLUSION

Acute acalculous cholecystitis was seen in a significant proportion of patients with dengue fever. All patients improved with good hydration and correction of thrombocytopenia. Based on these observations it is suggested that close observation and initial treatment of thrombocytopenia is mandatory.

Authors+Show Affiliations

Medical Unit 1, Civil Hospital Karachi, Dow University of Health Sciences, Karachi.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19757695

Citation

Bhatty, Shaheen, et al. "Acute Acalculous Cholecystitis in Dengue Fever." JPMA. the Journal of the Pakistan Medical Association, vol. 59, no. 8, 2009, pp. 519-21.
Bhatty S, Shaikh NA, Fatima M, et al. Acute acalculous cholecystitis in dengue fever. J Pak Med Assoc. 2009;59(8):519-21.
Bhatty, S., Shaikh, N. A., Fatima, M., & Sumbhuani, A. K. (2009). Acute acalculous cholecystitis in dengue fever. JPMA. the Journal of the Pakistan Medical Association, 59(8), 519-21.
Bhatty S, et al. Acute Acalculous Cholecystitis in Dengue Fever. J Pak Med Assoc. 2009;59(8):519-21. PubMed PMID: 19757695.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute acalculous cholecystitis in dengue fever. AU - Bhatty,Shaheen, AU - Shaikh,Niaz Ahmed, AU - Fatima,Mariam, AU - Sumbhuani,Aneel Kumar, PY - 2009/9/18/entrez PY - 2009/9/18/pubmed PY - 2010/9/15/medline SP - 519 EP - 21 JF - JPMA. The Journal of the Pakistan Medical Association JO - J Pak Med Assoc VL - 59 IS - 8 N2 - OBJECTIVE: To investigate the frequency, clinical features, management and outcome of acute acalculous cholecystitis in dengue fever patients. METHODS: Forty patients were admitted with the diagnosis of dengue fever, according to the clinical manifestations and laboratory investigations. The diagnosis of dengue fever was confirmed by a positive IgM antibody test result for a late or convalescent phase blood specimen. The diagnosis of acute acalculous cholecystitis was made according to clinical features and sonographic findings. Liver function tests, complete blood counts were determined. Abdominal ultrasound was performed with a real time scanner in patients with abdominal pain and abnormal results on liver function tests. RESULTS: Eleven out of 40 patients of dengue fever (27.5%) had complication of acute acalculous cholecystitis. There were 8 males and 3 females. The mean and standard deviation from the onset of fever to hospital visit was 3.3 +/- 0.8 days (range 2-5 days). The mean white cell counts was 4154 +/- 1577.5 cmm. The mean platelet counts were 26,727 +/- 10460.3 cmm on presentation in hospital. The mean SGPT level was 148.5 +/- 190.17 mg/dl. Mean alkaline phosphatase was 398 +/- 214.8 mg/dl. On sonography all had thickened gall bladder. The mean gall bladder wall thickness was 5.2 +/- 1.3 mm. Three patients had ascites and one patient had pleural effusion. CONCLUSION: Acute acalculous cholecystitis was seen in a significant proportion of patients with dengue fever. All patients improved with good hydration and correction of thrombocytopenia. Based on these observations it is suggested that close observation and initial treatment of thrombocytopenia is mandatory. SN - 0030-9982 UR - https://www.unboundmedicine.com/medline/citation/19757695/Acute_acalculous_cholecystitis_in_dengue_fever_ L2 - http://jpma.org.pk/full_article-text.php?article_id=1768 DB - PRIME DP - Unbound Medicine ER -