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Case report
Brucellosis, an uncommon cause of acute acalculous cholecystitis: two new cases and concise review
  1. Anis Hariz1,2,3,
  2. Imen Beji1,
  3. Mohamed Salah Hamdi1,2 and
  4. Eya Cherif1,2
  1. 1 Internal Medicine Department, Universite de Tunis El Manar Faculte de Medecine de Tunis, Tunis, Tunisia
  2. 2 Internal Medicine B, Hopital Charles Nicolle, Tunis, Tunisia
  3. 3 Research Laboratory of Kidney Diseases (LR00SP01), Charles Nicolle Hospital, Tunis, Tunisia
  1. Correspondence to Dr Anis Hariz, anis_hariz{at}yahoo.fr

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.

  • infectious diseases
  • surgery
  • pancreas and biliary tract
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Footnotes

  • Contributors AH participated in the conception of the idea, in the redaction and literature review for this manuscript. MSH participated in the redaction and literature review of the manuscript. IB participated in the conception of the idea and in the redaction and literature review of the manuscript. EC participated in the revision and checking of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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