Gallbladder perforation: A rare complication of enteric fever

Singh, Mahendra; Kumar, Love; Singh, Reetu R.; Jain, Aaron K.; Karande, Snehal K.; Saradna, Arjun; Prashanth, U

doi:10.1016/j.ijscr.2013.12.004

Cited by 13 publications

(21 citation statements)

References 10 publications

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“…Other GI and abdominal complications that have been reported to be associated with typhoid fever include acalculus cholecystitis, Gram negative sepsis leading to gall bladder gangrene and perforation, concomitant gall bladder and ileal perforation, duodenal ulceration with polyserositis, ileal ulceration with hematochezia, abdominal abscess, ovarian abscess, pancreatitis leading to pancreatic abscess, mesenteric lymphadenitis, and ascites. None of these complications were observed in any of our patient with typhoid fever [13,25,[27][28][29][30].…”

Section: Discussionmentioning

confidence: 97%

Gastrointestinal and Hepatobiliary Complications of Extensively Drug-Resistant Typhoid at a Tertiary Care Hospital in Pakistan

Mansoor¹,

Ahmed²,

Fida³

et al. 2020

Cureus

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Introduction: Typhoid fever is a major health problem in developing countries. Extensively drug-resistant (XDR) typhoid is an emerging threat to world health. The objectives of this study were to report our blood culture proven patients having XDR typhoid and compare the rate of gastrointestinal (GI) and hepatobiliary manifestations and complications of antimicrobial sensitive and resistant strains. Materials and methods: This prospective observational study was carried out at a tertiary care hospital in Pakistan, from January 2019 till August 2020 on all consecutive blood culture proven patients of Salmonella typhi. A total of 57 cases of Salmonella were identified, of which 10 were nonresistant, seven multi drugresistant (MDR), 39 extensively drug-resistant (XDR), and one was extended-spectrum beta lactamase (ESBL) positive. Alarmingly, one of the S. typhi isolate in addition to the first line drugs, was also resistant to azithromycin. Patients were treated with antibiotics according to antimicrobial susceptibility of the Salmonella in accordance with the World Health Organization (WHO) and Medical Microbiology and Infectious Diseases Society of Pakistan (MMIDSP) guidelines and GI and hepatobiliary complications were recorded. Results: Overall rate of complications was low. Some 10% (1/10) with nonresistant typhoid, 14% (1/7) with MDR, and 15% (6/39) of our patients with XDR typhoid fever had abdominal tenderness (p=0.95). None of the patients had GI bleeding, abdominal abscess, or peritonitis. Some 20% (2/10) patients with nonresistant typhoid, 29% (2/7) with MDR, and 18% (7/39) with XDR typhoid developed acute hepatitis, with greater than three times elevation of liver transaminases. There was no statistically significant difference in the occurrence of hepatitis between these groups (p=0.98). Interestingly, one of our patients with XDR typhoid also developed cholestatic hepatitis. Conclusion: There is no significant difference in GI and hepatobiliary complications amongst antimicrobial sensitive and resistant strains of typhoid. However, emergence of resistant strains calls for focus on prevention and judicious use of antimicrobials.

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Section: Discussionmentioning

confidence: 97%

Gastrointestinal and Hepatobiliary Complications of Extensively Drug-Resistant Typhoid at a Tertiary Care Hospital in Pakistan

Mansoor¹,

Ahmed²,

Fida³

et al. 2020

Cureus

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“…The possible causes may be infective bile from carriers, hematogenous spread from distant site, and lymphatic spread from gastrointestinal tract. Bilateral breast abscesses due to Salmonella typhi is a common presentation 4 After literature search, cases of breast abscess due to Salmonella species are very few. Amongst the species Salmonella typhi is more commonly reported than nontyphoidal salmonella.…”

Section: Salmonellamentioning

confidence: 99%

Recurrent breast abscess due to Salmonella paratyphi A: an unusual case

et al. 2014

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“…Already a rare entity, gallbladder perforation is extremely rare when it occurs as a complication of enteric fever [2]. The incidence of gallbladder perforation in enteric fever is around 3%-10% [3]. Salmonella, the causative agent of typhoid fever, has the ability to invade gallbladder epithelial cells, causing damage to the gallbladder wall, which then leads to perforation [4].…”

Section: Introductionmentioning

confidence: 99%

Gallbladder Perforation Secondary to Enteric Fever: An Interesting Case of Acute Abdomen

Malik

Mahmood

Din

et al. 2019

Cureus

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Enteric fever is a common infectious disease, especially in countries with poor sanitation and in the tropics. It is caused mainly by Salmonella typhi and accounts for nearly 27 million cases worldwide and 200,000 deaths annually. Enteric fever involves the reticuloendothelial system such as bone marrow, spleen, and liver. As it mostly involves the Peyer’s patches of the terminal ileum, enteric perforation occurs commonly. However, gallbladder perforation can also occur, though not very often. Ultrasound as well as computerized tomography (CT) abdomen and pelvis lack specificity for detecting gallbladder perforations in enteric fever. Diagnosis is usually confirmed intraoperatively when the gallbladder is visualized and perforation is seen. Gallbladder perforation is usually seen in acute cholecystitis when the gallbladder becomes necrotic and gangrenous. In acalculous cholecystitis, perforation is rare. Enteric fever is one of the rarest causes of acalculous cholecystitis, leading to perforation. Here, we present the case of a 20-year-old man who presented with fever for 10 days along with loose stools, vomiting, and acute abdomen. Labs showed leukopenia, positive Typhidot test but X-ray erect abdomen and ultrasound abdomen and pelvis were nonspecific. Only after resuscitation and exploration of the abdomen was it found that the gallbladder had multiple perforations. The patient was improved after eight days of postoperative intravenous antibiotics. This is a unique and rare presentation of such a common infectious disease.

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Gallbladder perforation: A rare complication of enteric fever

Cited by 13 publications

References 10 publications

Gastrointestinal and Hepatobiliary Complications of Extensively Drug-Resistant Typhoid at a Tertiary Care Hospital in Pakistan

Gastrointestinal and Hepatobiliary Complications of Extensively Drug-Resistant Typhoid at a Tertiary Care Hospital in Pakistan

Recurrent breast abscess due to Salmonella paratyphi A: an unusual case

Gallbladder Perforation Secondary to Enteric Fever: An Interesting Case of Acute Abdomen

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