Acalculous Acute Cholecystitis in Previously Healthy Children: General Overview and Analysis of Pediatric Infectious Cases

Poddighe, Dimitri; Tresoldi, Matteo; Licari, Amelia; Marseglia, Gian Luigi

doi:10.1155/2015/459608

Cited by 44 publications

(46 citation statements)

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“…1 Recently, we also reviewed acalculous acute cholecystitis (AAC) in previously healthy children, and described that most infectious cases of AAC were identified during EBV infection, in addition to hepatitis A virus hepatitis. 3 Interestingly, in our study severe EBV hepatitis was also associated with AAC. 2 Thus, a greater increase of c-GTP (often indicative of an underlying infectious AAC) might be associated with EBV infection more often, but further research including larger cases series is needed to support such a hypothesis.…”

supporting

confidence: 51%

Epstein–Barr virus hepatitis: Importance of PCR assay/serology and significance of γ‐GTP

Poddighe

2017

Pediatrics International

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supporting

confidence: 51%

Epstein–Barr virus hepatitis: Importance of PCR assay/serology and significance of γ‐GTP

Poddighe

2017

Pediatrics International

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“…A fisiopatologia não se encontra devidamente esclarecida, contudo, diversos fatores como isquemia, infeção e alterações estruturais e do conteúdo biliar estarão envolvidos. [1][2][3][4][5][6] Encontrava-se tipicamente associada a casos de prognóstico reservado, como doentes politraumatizados, queimaduras extensas e estados sépticos. 1,[4][5][6] No entanto, são cada vez mais os casos de colecistite aguda alitiásica descritos em outras situações, nomeadamente vasculites, como a doença de Kawasaki, e a várias infeções, como a infeção pelo vírus da hepatite A e vírus Epstein Barr.…”

Section: -3unclassified

“…1 Nesta série encontram-se dois casos relacionados com colecistite aguda alitiásica que surgiu após gastroenterite por Salmonella, mais especificamente por Salmonella typhi e por Salmonella enteritidis. 7,8 Sabe-se que a infeção por Salmonella tem várias complicações associadas, como desidratação e bacteriemia.…”

Section: -4unclassified

“…Desta forma, o diagnóstico deverá ser estabelecido pelo enquadramento da clínica, avaliação analítica com os achados característicos à ecografia abdominal. [1][2][3][4] No caso apresentado, à semelhança de outros casos descritos, [2][3][4][5][6][7][8] o doente foi tratado de forma conservadora e apresentou evolução favorável. Realça-se um quadro de colecistite aguda alitiásica não associada a doença sistémica grave, reforçando a tendência atual, e ilustra--se que a gastroenterite por Salmonella não tifoide, dentro das diversas complicações descritas, poderá complicar-se com colecistite aguda alitiásica e que o diagnóstico deverá ser suspeitado face à persistência das queixas sugestivas.…”

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Colecistite Aguda Alitiásica por Salmonella enteritidis

Damião

Gouveia

2018

Acta Pediátrica Port

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A colecistite aguda alitiásica define-se como a inflamação aguda da vesícula biliar na ausência de cálculos. Em pediatria representa a principal patologia aguda da vesícula biliar. Anteriormente associada a casos de mau prognóstico e de doença sistémica grave, são cada vez mais os casos de colecistite aguda alitiásica em crianças previamente saudáveis, com patologia infeciosa. A associação com Salmonella enteritidis é pouco frequente. Apresenta-se o caso clínico de um rapaz de 7 anos internado por desidratação no contexto de gastroenterite por Salmonella enteritidis, complicada por colecistite aguda alitiásica. Evoluiu bem após antibioterapia endovenosa, sem necessidade de intervenção cirúrgica. O tropismo da Salmonella pela vesícula biliar é um assunto pouco esclarecido, pelo que é revista resumidamente a literatura mais recente.Palavras-chave: Colecistite Acalculosa; Criança; Infeções por Salmonella; Salmonella enteritidis AbstractAcute acalculous cholecystitis is defined as acute inflammation of the gallbladder in the absence of gallstones. In paediatrics it is the main acute pathology of the gallbladder. Initially described in critically ill patients, nowadays most cases are observed in previously healthy children secondary to infections. Association with Salmonella enteritidis infection is rare. The authors report the case of a 7-year-old boy admitted to hospital due to dehydration in the context of Salmonella enteritidis gastroenteritis, complicated by acute acalculous cholecystitis. After intravenous antibiotic therapy, laboratory parameters normalized and the patient's clinical course was favourable without the need for surgical treatment. Tropism of Salmonella for the gallbladder is well-known but not well understood; here we review the most recent literature on the subject.

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“…Some malignancies, especially hemophagocytic lymphocytosis and long‐term total parenteral nutrition were described as AAC risk factors . In addition, congenital gallbladder malformations, congenital biliary duct anomalies and acquired disorders that cause biliary stasis have been reported to be risk factors for childhood cholecystitis …”

Section: Introductionmentioning

confidence: 99%

Epstein‐Barr virus infection with acute acalculous cholecystitis in previously healthy children

Mazur‐Melewska¹,

Derwich²,

Mania³

et al. 2019

Int J Clin Pract

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Background Acute acalculous cholecystitis (AAC), an inflammatory process of the gallbladder (GB) in the absence of gallstones, typically occurs in seriously ill patients. AAC can complicate primary Epstein‐Barr virus (EBV) infection, but it is an atypical clinical presentation. Aim The aim of our study was to analyse AAC occurrence in children with primary symptomatic EBV infection who had been admitted to the hospital. Methods We retrospectively evaluated the medical documentation of 181 children with EBV infection who were diagnosed based on the presence of viral capsid antigen IgM antibodies. All EBV‐positive patients underwent transabdominal ultrasonography of the liver in the supine and right anterior oblique positions. Fifteen children who presented with AAC symptoms, including abdominal pain and a positive Murphy's sign, were analysed as a subsample and re‐evaluated after 2‐3 months. Results The incidence of AAC in children hospitalised with infectious mononucleosis (IM) was estimated at 8.3%. Analysis of the laboratory results confirmed that the C‐reactive protein (CRP) concentration was the only parameter which was higher in children who presented with AAC symptoms. The mean number of leucocytes and monocytes and liver enzyme activities were not significantly higher. The radiological findings of AAC were evident: increased GB wall thickness, non‐shadowing echogenic sludge and pericholecystic fluid collection. Conclusion AAC during primary EBV infection appears to be a more common pathology than previously suspected. Its relatively mild nature and the lack of laboratory abnormalities mean that ultrasonographic examination is required for diagnosis. This might explain why the prevalence in children is underestimated.

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Acalculous Acute Cholecystitis in Previously Healthy Children: General Overview and Analysis of Pediatric Infectious Cases

Cited by 44 publications

References 50 publications

Epstein–Barr virus hepatitis: Importance of PCR assay/serology and significance of γ‐GTP

Epstein–Barr virus hepatitis: Importance of PCR assay/serology and significance of γ‐GTP

Colecistite Aguda Alitiásica por Salmonella enteritidis

Epstein‐Barr virus infection with acute acalculous cholecystitis in previously healthy children

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