1/5. Acute acalculous cholecystitis in leptospirosis.The authors present three patients with acalculous cholecystitis seen at a tertiary care center in Bangkok. The first patient was explored surgically because peritonitis was suspected. The two other patients were treated conservatively with antibiotics and supportive care, and they recovered fully. The diagnosis of leptospirosis was confirmed by increasing antibody titers in three patients and by blood culture in one patient. leptospira were not detected in the surgical specimen. leptospirosis is a systemic disease that can present with a multitude of symptoms and signs including right upper quadrant pain mimicking cholecystitis. A high level of awareness and appropriate laboratory studies should allow early diagnosis and may prevent unnecessary surgical intervention.- - - - - - - - - - ranking = 1keywords = cholecystitis (Clic here for more details about this article) |
2/5. leptospirosis mimicking acute cholecystitis among athletes participating in a triathlon.leptospirosis, a disease acquired by exposure to contaminated water, is characterized by fever accompanied by various symptoms, including abdominal pain. An acute febrile illness occurred in athletes who participated in an illinois triathlon in which the swimming event took place in a freshwater lake. Of 876 athletes, 120 sought medical care and 22 were hospitalized. Two of the athletes had their gallbladders removed because of abdominal pain and clinical suspicion of acute cholecystitis. We applied an immunohistochemical test for leptospirosis to these gallbladders and demonstrated bacterial antigens staining (granular and filamentous patterns) around blood vessels of the serosa and muscle layer. Rare intact bacteria were seen in 1 case. These results show that leptospirosis can mimic the clinical symptoms of acute cholecystitis. If a cholecystectomy is performed in febrile patients with suspicious environmental or animal exposure, pathologic studies for leptospirosis on formalin-fixed, paraffin-embedded tissues may be of great value.- - - - - - - - - - ranking = 1keywords = cholecystitis (Clic here for more details about this article) |
3/5. Acute acalculous cholecystitis and pancreatitis in a patient with concomitant leptospirosis and scrub typhus.Concomitant leptospirosis and scrub typhus is rare. The spectrum of clinical severity for both scrub typhus and leptospirosis ranges from mild to fatal. Acute pancreatitis and cholecystitis are infrequent complications in adult patients with either leptospirosis or scrub typhus. We report a case of leptospirosis and scrub typhus coinfection in a 41-year-old man presenting with acute acalculous cholecystitis, pancreatitis and acute renal failure. Abdominal computed tomography revealed edematous change of the gallbladder without intrahepatic or pancreatic lesions. The patient was successfully treated with doxycycline and ceftriaxone, and supportive management.- - - - - - - - - - ranking = 1keywords = cholecystitis (Clic here for more details about this article) |
4/5. leptospirosis: a childhood disease.A diagnosis of leptospirosis was confirmed in nine children who were admitted to St. Louis Children's Hospital during the past 54 months. Epidemiologic, clinical, cultural, and serologic data which were obtained emphasize (1) the high incidence of urban cases; (2) contact with dogs as the most likely source of infection; and (3) that serotypes other than leptospira icterohaemorrhagiae may produce severe clinical disease. Unusual or previously unreported manifestations of leptospirosis including acalculous cholecystitis, pancreatitis, abdominal causalgia, desquamating skin rashes, and infarction of the extremities which were noted in these children are discussed.- - - - - - - - - - ranking = 0.16666666666667keywords = cholecystitis (Clic here for more details about this article) |
5/5. leptospirosis with acute acalculous cholecystitis and pancreatitis.Severe leptospira autumnalis infection was associated with acute acalculous cholecystitis and pancreatitis in a 66-year-old man. He was successfully treated with antimicrobial agents and supportive therapy, including hemodialysis. We review these uncommon manifestations and the effectiveness of antimicrobial therapy in advanced leptospirosis.- - - - - - - - - - ranking = 0.83333333333333keywords = cholecystitis (Clic here for more details about this article) |