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Acute HIV infection with presentations mimicking acalculous cholecystitis: A case report.
Medicine (Baltimore). 2021 Jul 16; 100(28):e26653.M

Abstract

RATIONALE

Acute retroviral syndrome is the symptomatic presentation of acute human immunodeficiency virus (HIV) infection, which often manifests as a self-limited infectious mononucleosis-like syndrome and occurs 2 to 6 weeks after exposure to HIV. Atypical manifestations including hepatitis, meningitis, or hemophagocytic lymphohistiocytosis have been reported. However, manifestations of acute acalculous cholecystitis during acute HIV infection are rarely reported.

PATIENT CONCERNS

A 30-year-old man with nausea and loose stools, followed by fever and abdominal pain at the right upper quadrant for 10 days.

DIAGNOSIS

Acute retroviral syndrome, complicated with acute acalculous cholecystitis.

INTERVENTIONS

Percutaneous transhepatic gallbladder drainage was performed and treatment with co-formulated bictegravir/emtricitabine/tenofovir alafenamide was initiated upon HIV diagnosis.

OUTCOMES

The patient's symptoms improved after the drainage. The levels of liver enzyme including aspartate transaminase alanine aminotransferase decreased to a level within normal limits 1 month after initiation of antiretroviral therapy.

CONCLUSION

Acalculous cholecystitis in combination with acute hepatitis could be manifestations of acute HIV infection. For individuals at risk of acquiring HIV infection who present with manifestations of acute acalculous cholecystitis, HIV testing should be considered.

Authors+Show Affiliations

Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan.School of Pharmacy, National Taiwan University, Taipei, Taiwan.School of Pharmacy, National Taiwan University, Taipei, Taiwan.School of Pharmacy, National Taiwan University, Taipei, Taiwan.Department of Laboratory Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan. Department of Medical Research, China Medical University Hospital, Taichung, Taiwan. China Medical University, Taichung, Taiwan.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

34260568

Citation

Liu, Wang-Da, et al. "Acute HIV Infection With Presentations Mimicking Acalculous Cholecystitis: a Case Report." Medicine, vol. 100, no. 28, 2021, pp. e26653.
Liu WD, Cheng CN, Lin YT, et al. Acute HIV infection with presentations mimicking acalculous cholecystitis: A case report. Medicine (Baltimore). 2021;100(28):e26653.
Liu, W. D., Cheng, C. N., Lin, Y. T., Kuo, C. H., Ho, S. Y., & Hung, C. C. (2021). Acute HIV infection with presentations mimicking acalculous cholecystitis: A case report. Medicine, 100(28), e26653. https://doi.org/10.1097/MD.0000000000026653
Liu WD, et al. Acute HIV Infection With Presentations Mimicking Acalculous Cholecystitis: a Case Report. Medicine (Baltimore). 2021 Jul 16;100(28):e26653. PubMed PMID: 34260568.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute HIV infection with presentations mimicking acalculous cholecystitis: A case report. AU - Liu,Wang-Da, AU - Cheng,Chih-Ning, AU - Lin,Ya-Ting, AU - Kuo,Ching-Hua, AU - Ho,Shu-Yuan, AU - Hung,Chien-Ching, PY - 2021/02/03/received PY - 2021/06/28/accepted PY - 2021/7/14/entrez PY - 2021/7/15/pubmed PY - 2021/7/30/medline SP - e26653 EP - e26653 JF - Medicine JO - Medicine (Baltimore) VL - 100 IS - 28 N2 - RATIONALE: Acute retroviral syndrome is the symptomatic presentation of acute human immunodeficiency virus (HIV) infection, which often manifests as a self-limited infectious mononucleosis-like syndrome and occurs 2 to 6 weeks after exposure to HIV. Atypical manifestations including hepatitis, meningitis, or hemophagocytic lymphohistiocytosis have been reported. However, manifestations of acute acalculous cholecystitis during acute HIV infection are rarely reported. PATIENT CONCERNS: A 30-year-old man with nausea and loose stools, followed by fever and abdominal pain at the right upper quadrant for 10 days. DIAGNOSIS: Acute retroviral syndrome, complicated with acute acalculous cholecystitis. INTERVENTIONS: Percutaneous transhepatic gallbladder drainage was performed and treatment with co-formulated bictegravir/emtricitabine/tenofovir alafenamide was initiated upon HIV diagnosis. OUTCOMES: The patient's symptoms improved after the drainage. The levels of liver enzyme including aspartate transaminase alanine aminotransferase decreased to a level within normal limits 1 month after initiation of antiretroviral therapy. CONCLUSION: Acalculous cholecystitis in combination with acute hepatitis could be manifestations of acute HIV infection. For individuals at risk of acquiring HIV infection who present with manifestations of acute acalculous cholecystitis, HIV testing should be considered. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/34260568/Acute_HIV_infection_with_presentations_mimicking_acalculous_cholecystitis:_A_case_report_ L2 - https://doi.org/10.1097/MD.0000000000026653 DB - PRIME DP - Unbound Medicine ER -