Korean J Pancreas Biliary Tract.  2015 Jul;20(3):162-167. 10.15279/kpba.2015.20.3.162.

A Case of Acute Cholecystitis Caused by Plasmodium vivax Infection

• Yang BK
• Kang JG
• Oh HM
• Park HS
• Kim KU
• Cho SJ
• Cho HJ
• Lee JH

• KMID: 2448493
• DOI: http://doi.org/10.15279/kpba.2015.20.3.162

Abstract

Acute cholecystitis as a complication of malarial disease is a rare condition, especially with Plasmodium vivax infection. A 62 year-old-female was admitted via emergency room (ER) due to high fever (40.3degrees C) and epigastric pain. Initial abdominal ultrasound and computed tomography (CT) scan showed edematous gallbladder with stone, which suggested acute calculous cholecystitis. Emergency percutaneous transhepatic gallbladder drainage (PTGBD) was done with systemic antibiotic therapy. The clinical course, however, unusually worsened with hypotension and intensive care unit (ICU) management was done. Four days after admission multi-focal splenic infarction was developed and Plasmodium vivax infection was diagnosed afterward. The clinical symptoms and laboratory results, including fever and epigastric pain, improved dramatically after anti-malarial treatment and cholecystectomy was done. The resected gallbladder (GB) specimen shows vasculitis pattern with capillary red blood cell (RBC) engorgement, which suggests the cause of cholecystitis was due to Plasmodium vivax rather than GB stone.

Keyword

Acute cholecystitis; Splenic infarction; Plasmodium vivax

MeSH Terms

Capillaries
Cholecystectomy
Cholecystitis
Cholecystitis, Acute*
Drainage
Emergencies
Emergency Service, Hospital
Erythrocytes
Fever
Gallbladder
Hypotension
Intensive Care Units
Plasmodium vivax*
Plasmodium*
Splenic Infarction
Ultrasonography
Vasculitis