Acute Acalculous Cholecystitis Caused by Candida albicans Secondary to COVID-19 Infection

Abstract

Introduction: Acute acalculous cholecystitis is an acute gallbladder inflammation in the absence of cholelithiasis associated with high morbidity and mortality rates. Fungal organisms are an infrequent cause of gallbladder infections. Although many coronavirus disease-19 (COVID-19) patients reported gastrointestinal symptoms, there is little evidence of gallbladder and biliary tract involvement. we report a case of fungal acute acalculous cholecystitis secondary to COVID-19. Case Presentation: A 71-year-old man with a past medical history of benign prostatic hyperplasia, essential hypertension, and hyperlipidemia was admitted for COVID-19 and received appropriate treatment with dexamethasone, remdesivir, and convalescent plasma. The patient continued to be lethargic, weak, and had elevated inflammatory markers. He was transferred to the intensive care unit (ICU) for intubation and mechanical ventilation. The total bilirubin started to increase over the following days and reached 8 mg/dL (136.8 μmol/L). The ultrasound did not show cholelithiasis and the bile culture grew Candida albicans, indicating acalculous Candida cholecystitis. The patient had a significant deterioration in clinical status and passed away after being transferred to comfort care. Conclusion: Our case represents acute acalculous cholecystitis possibly secondary to COVID-19 infection that was resulted in an invasive fungal infection involving the gallbladder Future research could help facilitate a better pathophysiological understanding of gallbladder complications and provide a more precise explanation of the long-term effects of COVID-19.