Cargando…

A Case of Melioidosis Presenting as Acalculous Cholecystitis

We describe a case of melioidosis presenting as acalculous cholecystitis in a middle-aged Chinese male. The patient presented with clinical features of cholecystitis and computed tomography (CT) imaging did not reveal other obvious sources of sepsis other than acalculous cholecystitis. The decision...

Descripción completa

Detalles Bibliográficos
Autores principales: Ye, QinHao Jonathan, Desai, Suneel Ramesh, Tan, Ek Khoon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6107038/
https://www.ncbi.nlm.nih.gov/pubmed/30148016
http://dx.doi.org/10.7759/cureus.2864
_version_ 1783349899869290496
author Ye, QinHao Jonathan
Desai, Suneel Ramesh
Tan, Ek Khoon
author_facet Ye, QinHao Jonathan
Desai, Suneel Ramesh
Tan, Ek Khoon
author_sort Ye, QinHao Jonathan
collection PubMed
description We describe a case of melioidosis presenting as acalculous cholecystitis in a middle-aged Chinese male. The patient presented with clinical features of cholecystitis and computed tomography (CT) imaging did not reveal other obvious sources of sepsis other than acalculous cholecystitis. The decision was made by the hepatobiliary team to proceed with an urgent cholecystectomy in view of patient's septic presentation. Cultures from peripheral blood and intraoperatively obtained bile fluid grew Burkholderia pseudomallei. The patient subsequently completed one month of meropenem, followed by another three months of eradication therapy. The patient denied soil contact in his work but he comes from a melioidosis-endemic country. He was also newly diagnosed with diabetes mellitus during his admission. We believe this to be the first reported case of melioidosis presenting as acalculous cholecystitis with a positive bile fluid culture. Urgent cholecystectomy in susceptible cases, with positive contact history or from endemic countries, might present another modality to achieve source control. Appropriate antibiotics with melioidosis coverage should be started early as well.
format Online
Article
Text
id pubmed-6107038
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-61070382018-08-24 A Case of Melioidosis Presenting as Acalculous Cholecystitis Ye, QinHao Jonathan Desai, Suneel Ramesh Tan, Ek Khoon Cureus Internal Medicine We describe a case of melioidosis presenting as acalculous cholecystitis in a middle-aged Chinese male. The patient presented with clinical features of cholecystitis and computed tomography (CT) imaging did not reveal other obvious sources of sepsis other than acalculous cholecystitis. The decision was made by the hepatobiliary team to proceed with an urgent cholecystectomy in view of patient's septic presentation. Cultures from peripheral blood and intraoperatively obtained bile fluid grew Burkholderia pseudomallei. The patient subsequently completed one month of meropenem, followed by another three months of eradication therapy. The patient denied soil contact in his work but he comes from a melioidosis-endemic country. He was also newly diagnosed with diabetes mellitus during his admission. We believe this to be the first reported case of melioidosis presenting as acalculous cholecystitis with a positive bile fluid culture. Urgent cholecystectomy in susceptible cases, with positive contact history or from endemic countries, might present another modality to achieve source control. Appropriate antibiotics with melioidosis coverage should be started early as well. Cureus 2018-06-22 /pmc/articles/PMC6107038/ /pubmed/30148016 http://dx.doi.org/10.7759/cureus.2864 Text en Copyright © 2018, Ye et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Ye, QinHao Jonathan
Desai, Suneel Ramesh
Tan, Ek Khoon
A Case of Melioidosis Presenting as Acalculous Cholecystitis
title A Case of Melioidosis Presenting as Acalculous Cholecystitis
title_full A Case of Melioidosis Presenting as Acalculous Cholecystitis
title_fullStr A Case of Melioidosis Presenting as Acalculous Cholecystitis
title_full_unstemmed A Case of Melioidosis Presenting as Acalculous Cholecystitis
title_short A Case of Melioidosis Presenting as Acalculous Cholecystitis
title_sort case of melioidosis presenting as acalculous cholecystitis
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6107038/
https://www.ncbi.nlm.nih.gov/pubmed/30148016
http://dx.doi.org/10.7759/cureus.2864
work_keys_str_mv AT yeqinhaojonathan acaseofmelioidosispresentingasacalculouscholecystitis
AT desaisuneelramesh acaseofmelioidosispresentingasacalculouscholecystitis
AT tanekkhoon acaseofmelioidosispresentingasacalculouscholecystitis
AT yeqinhaojonathan caseofmelioidosispresentingasacalculouscholecystitis
AT desaisuneelramesh caseofmelioidosispresentingasacalculouscholecystitis
AT tanekkhoon caseofmelioidosispresentingasacalculouscholecystitis