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Brucellosis, an uncommon cause of acute acalculous cholecystitis: two new cases and concise review.
BMJ Case Rep. 2019 Sep 06; 12(9)BC

Abstract

Acalculous cholecystitis etiologies while numerous, some of them are less-known such as brucellosis. In this report, we elaborate the clinical findings, investigations and management of two female patients presenting acalculous cholecystitis in whom diagnosis of acute brucellosis was retained. Both patients had fever, asthenia and abdominal tenderness. Laboratory results showed evidence of inflammation as well as hepatic cytolysis while cholestasis was noted in one patient. In both cases, ultrasound study and CT confirmed the presence of acalculous cholecystitis. Serology (tube agglutination test) led to the diagnosis of brucellosis. Diagnosis of brucellosis-related acute cholecystitis was established in both cases based on imaging findings as well as serology without resorting to cholecystectomy. Favourable clinical response to specific antibiotic therapy further supported our diagnosis as well as our decision to avoid surgery. Although few cases have been reported, brucellosis must be considered as a cause of acalculous cholecystitis, especially in endemic countries.

Authors+Show Affiliations

Internal Medicine Department, Universite de Tunis El Manar Faculte de Medecine de Tunis, Tunis, Tunisia. Internal Medicine B, Hopital Charles Nicolle, Tunis, Tunisia. Research Laboratory of Kidney Diseases (LR00SP01), Charles Nicolle Hospital, Tunis, Tunisia.Internal Medicine Department, Universite de Tunis El Manar Faculte de Medecine de Tunis, Tunis, Tunisia.Internal Medicine Department, Universite de Tunis El Manar Faculte de Medecine de Tunis, Tunis, Tunisia. Internal Medicine B, Hopital Charles Nicolle, Tunis, Tunisia.Internal Medicine Department, Universite de Tunis El Manar Faculte de Medecine de Tunis, Tunis, Tunisia. Internal Medicine B, Hopital Charles Nicolle, Tunis, Tunisia.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

31494582

Citation

Hariz, Anis, et al. "Brucellosis, an Uncommon Cause of Acute Acalculous Cholecystitis: Two New Cases and Concise Review." BMJ Case Reports, vol. 12, no. 9, 2019.
Hariz A, Beji I, Hamdi MS, et al. Brucellosis, an uncommon cause of acute acalculous cholecystitis: two new cases and concise review. BMJ Case Rep. 2019;12(9).
Hariz, A., Beji, I., Hamdi, M. S., & Cherif, E. (2019). Brucellosis, an uncommon cause of acute acalculous cholecystitis: two new cases and concise review. BMJ Case Reports, 12(9). https://doi.org/10.1136/bcr-2019-229616
Hariz A, et al. Brucellosis, an Uncommon Cause of Acute Acalculous Cholecystitis: Two New Cases and Concise Review. BMJ Case Rep. 2019 Sep 6;12(9) PubMed PMID: 31494582.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Brucellosis, an uncommon cause of acute acalculous cholecystitis: two new cases and concise review. AU - Hariz,Anis, AU - Beji,Imen, AU - Hamdi,Mohamed Salah, AU - Cherif,Eya, Y1 - 2019/09/06/ PY - 2019/9/9/entrez PY - 2019/9/9/pubmed PY - 2020/2/11/medline KW - infectious diseases KW - pancreas and biliary tract KW - surgery JF - BMJ case reports JO - BMJ Case Rep VL - 12 IS - 9 N2 - Acalculous cholecystitis etiologies while numerous, some of them are less-known such as brucellosis. In this report, we elaborate the clinical findings, investigations and management of two female patients presenting acalculous cholecystitis in whom diagnosis of acute brucellosis was retained. Both patients had fever, asthenia and abdominal tenderness. Laboratory results showed evidence of inflammation as well as hepatic cytolysis while cholestasis was noted in one patient. In both cases, ultrasound study and CT confirmed the presence of acalculous cholecystitis. Serology (tube agglutination test) led to the diagnosis of brucellosis. Diagnosis of brucellosis-related acute cholecystitis was established in both cases based on imaging findings as well as serology without resorting to cholecystectomy. Favourable clinical response to specific antibiotic therapy further supported our diagnosis as well as our decision to avoid surgery. Although few cases have been reported, brucellosis must be considered as a cause of acalculous cholecystitis, especially in endemic countries. SN - 1757-790X UR - https://www.unboundmedicine.com/medline/citation/31494582/Brucellosis_an_uncommon_cause_of_acute_acalculous_cholecystitis:_two_new_cases_and_concise_review_ L2 - https://casereports.bmj.com/lookup/pmidlookup?view=long&pmid=31494582 DB - PRIME DP - Unbound Medicine ER -