Case Report
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Acute Acalculous Cholecystitis as a Rare Initial Presentation of Epstein-Barr Virus Infection in an Immunocompetent Adult Female

Year 2024, Volume: 4 Issue: 3, 71 - 76, 29.07.2024
https://doi.org/10.56016/dahudermj.1429174

Abstract

Epstein-Barr virus (EBV) infection is a self-limited disease usually characterized by a sore throat, fever, and lymphadenopathy. Mild to moderate hepatitis may also occur during the course of the infection. The disease is very rarely complicated with acalculous cholecystitis. Herein, we report a 22-year-old immunocompetent female patient who initially presented with fever and moderate abdominal pain that was revealed to be due to acute acalculous cholecystitis. The EBV infection was diagnosed both clinically and serologically. Typical findings of sore throat and cervical lymphadenopathy appeared later the fifth day of admission. In this case report, the patient was treated conservatively, without surgery. Atypical presentation, inverse timing of clinical manifestations, and the conservative management of acalculous cholecystitis in contrast to critically ill patients’ acalculous cholecystitis management are noteworthy for both surgeons and internists to be aware of.

References

  • Womack J, Jimenez M. Common questions about infectious mononucleosis. Am Fam Physician. 2015 Mar 15;91(6):372-6. PMID: 25822555.
  • Dunmire SK, Verghese PS, Balfour HH Jr. Primary Epstein-Barr virus infection. J Clin Virol. 2018 May;102:84-92. doi: 10.1016/j.jcv.2018.03.001. Epub 2018 Mar 5. PMID: 29525635.
  • Odumade OA, Hogquist KA, Balfour HH Jr. Progress and problems in understanding and managing primary Epstein-Barr virus infections. Clin Microbiol Rev. 2011 Jan;24(1):193-209. doi: 10.1128/CMR.00044-10.
  • Shaukat A, Tsai HT, Rutherford R, Anania FA. Epstein-Barr virus induced hepatitis: An important cause of cholestasis. Hepatol Res. 2005 Sep;33(1):24-6. doi: 10.1016/j.hepres.2005.06.005. Epub 2005 Aug 19.
  • Putukian M, O’Connor FG, Stricker P, McGrew C, Hosey RG, Gordon SM, Kinderknecht J, Kriss V, Landry G. Mononucleosis and athletic participation: an evidence-based subject review. Clin J Sport Med. 2008 Jul;18(4):309-15. doi: 10.1097/JSM.0b013e31817e34f8.
  • Fugl A, Andersen CL. Epstein-Barr virus and its association with disease - a review of relevance to general practice. BMC Fam Pract. 2019 May 14;20(1):62. doi: 10.1186/s12875-019-0954-3.
  • Boninsegna S, Storato S, Riccardi N, Soprana M, Oliboni E, Tamarozzi F, Bocus P, Martini M, Floreani A. Epstein-Barr Virus (EBV) acute acalculous cholecystitis in an immunocompromised adult patient: a case report and a literature review of a neglected clinical presentation. J Prev Med Hyg. 2021 Apr 29;62(1):E237-E242. doi: 10.15167/2421-4248/jpmh2021.62.1.1859. Erratum in: J Prev Med Hyg. 2021 Jul 30;62(2):E574.
  • Kim A, Yang HR, Moon JS, Chang JY, Ko JS. Epstein-barr virus infection with acute acalculous cholecystitis. Pediatr Gastroenterol Hepatol Nutr. 2014 Mar;17(1):57-60. doi: 10.5223/pghn.2014.17.1.57. Epub 2014 Mar 31.
  • Branco L, Vieira M, Couto C, Coelho MD, Laranjeira C. Acute Acalculous Cholecystitis by Epstein-Barr Virus Infection: A Rare Association. Infect Dis Rep. 2015 Dec 22;7(4):6184. doi: 10.4081/idr.2015.6184.
  • Barie PS, Eachempati SR. Acute acalculous cholecystitis. Curr Gastroenterol Rep. 2003 Aug;5(4):302-9. doi: 10.1007/s11894-003-0067-x.
  • Havrilla TR, Reich NE, Haaga JR, Seidelmann FE, Cooperman AM, Alfidi RJ. Computed tomography of the gallbladder. AJR Am J Roentgenol. 1978 Jun;130(6):1059-67. doi: 10.2214/ajr.130.6.1059.
  • Robertson F, Leander P, Ekberg O. Radiology of the spleen. Eur Radiol. 2001;11(1):80-95. doi: 10.1007/s003300000528.
Year 2024, Volume: 4 Issue: 3, 71 - 76, 29.07.2024
https://doi.org/10.56016/dahudermj.1429174

Abstract

References

  • Womack J, Jimenez M. Common questions about infectious mononucleosis. Am Fam Physician. 2015 Mar 15;91(6):372-6. PMID: 25822555.
  • Dunmire SK, Verghese PS, Balfour HH Jr. Primary Epstein-Barr virus infection. J Clin Virol. 2018 May;102:84-92. doi: 10.1016/j.jcv.2018.03.001. Epub 2018 Mar 5. PMID: 29525635.
  • Odumade OA, Hogquist KA, Balfour HH Jr. Progress and problems in understanding and managing primary Epstein-Barr virus infections. Clin Microbiol Rev. 2011 Jan;24(1):193-209. doi: 10.1128/CMR.00044-10.
  • Shaukat A, Tsai HT, Rutherford R, Anania FA. Epstein-Barr virus induced hepatitis: An important cause of cholestasis. Hepatol Res. 2005 Sep;33(1):24-6. doi: 10.1016/j.hepres.2005.06.005. Epub 2005 Aug 19.
  • Putukian M, O’Connor FG, Stricker P, McGrew C, Hosey RG, Gordon SM, Kinderknecht J, Kriss V, Landry G. Mononucleosis and athletic participation: an evidence-based subject review. Clin J Sport Med. 2008 Jul;18(4):309-15. doi: 10.1097/JSM.0b013e31817e34f8.
  • Fugl A, Andersen CL. Epstein-Barr virus and its association with disease - a review of relevance to general practice. BMC Fam Pract. 2019 May 14;20(1):62. doi: 10.1186/s12875-019-0954-3.
  • Boninsegna S, Storato S, Riccardi N, Soprana M, Oliboni E, Tamarozzi F, Bocus P, Martini M, Floreani A. Epstein-Barr Virus (EBV) acute acalculous cholecystitis in an immunocompromised adult patient: a case report and a literature review of a neglected clinical presentation. J Prev Med Hyg. 2021 Apr 29;62(1):E237-E242. doi: 10.15167/2421-4248/jpmh2021.62.1.1859. Erratum in: J Prev Med Hyg. 2021 Jul 30;62(2):E574.
  • Kim A, Yang HR, Moon JS, Chang JY, Ko JS. Epstein-barr virus infection with acute acalculous cholecystitis. Pediatr Gastroenterol Hepatol Nutr. 2014 Mar;17(1):57-60. doi: 10.5223/pghn.2014.17.1.57. Epub 2014 Mar 31.
  • Branco L, Vieira M, Couto C, Coelho MD, Laranjeira C. Acute Acalculous Cholecystitis by Epstein-Barr Virus Infection: A Rare Association. Infect Dis Rep. 2015 Dec 22;7(4):6184. doi: 10.4081/idr.2015.6184.
  • Barie PS, Eachempati SR. Acute acalculous cholecystitis. Curr Gastroenterol Rep. 2003 Aug;5(4):302-9. doi: 10.1007/s11894-003-0067-x.
  • Havrilla TR, Reich NE, Haaga JR, Seidelmann FE, Cooperman AM, Alfidi RJ. Computed tomography of the gallbladder. AJR Am J Roentgenol. 1978 Jun;130(6):1059-67. doi: 10.2214/ajr.130.6.1059.
  • Robertson F, Leander P, Ekberg O. Radiology of the spleen. Eur Radiol. 2001;11(1):80-95. doi: 10.1007/s003300000528.
There are 12 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Case Reports
Authors

Alper Tuna Güven 0000-0002-6310-4240

Burak Çevirici 0009-0002-7203-0869

Gamze Gürsoy 0000-0002-7825-4065

Publication Date July 29, 2024
Submission Date January 31, 2024
Acceptance Date April 24, 2024
Published in Issue Year 2024 Volume: 4 Issue: 3

Cite

EndNote Güven AT, Çevirici B, Gürsoy G (July 1, 2024) Acute Acalculous Cholecystitis as a Rare Initial Presentation of Epstein-Barr Virus Infection in an Immunocompetent Adult Female. DAHUDER Medical Journal 4 3 71–76.



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