TY - JOUR T1 - Brucellosis, an uncommon cause of acute acalculous cholecystitis: two new cases and concise review JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2019-229616 VL - 12 IS - 9 SP - e229616 AU - Anis Hariz AU - Imen Beji AU - Mohamed Salah Hamdi AU - Eya Cherif Y1 - 2019/09/01 UR - http://casereports.bmj.com/content/12/9/e229616.abstract 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. ER -