A case of acalculous cholecystitis or Brucella-induced acute cholecystitis?

Abstract

Brucella spp. is a microorganism that can cause febrile, systemic infection, especially in endemic areas. Although it causes a multisystemic involvement and creates various clinical symptoms, osteoarticular symptoms are the most common. However, Brucella spp. is known to be a great mimic and can cause rare, atypical presentations. In this case report, we aimed to present a 67-year-old Turkish female patient diagnosed with stony cholecystitis due to Brucella spp. Although rare, brucellosis can be encountered as a cause of acute cholecyst. Although there are changes in the epidemiology of brucellosis, it is useful to keep in mind brucellosis in the differential diagnosis of many diseases, in endemic areas, especially in rural areas.

Keywords

• Brucellosis
• Brucella
• Cholecystitis
• Endemic
• Atypical presentations

References

1. Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) , Division of High-Consequence Pathogens and Pathology (DHCPP)
2. Deng Y, Liu X, Duan K, Peng Q. Research Progress on Brucellosis. Curr Med Chem. 2019;26(30):5598-5608. https://doi.org/10.2174/0929867325666180510125009
3. Speiser L, Hsieh L, Huang SS, Bittencourt C, Forthal D. Brucellosis Presenting as Cholecystitis: A Case Report and Literature Review. Open Forum Infect Dis. 2019;6(10):ofz334. https://doi.org/10.1093/ofid/ofz334
4. Miranda RT, Gimeno AE, Rodriguez TF, de Arriba JJ, Olmo DG, Solera J. Acute cholecystitis caused by Brucella melitensis: case report and review. J Infect. 2001;42(1):77-8. https://doi.org/10.1053/jinf.2000.0757
5. Ergün U. Brucellosis associated with acute cholecystitis. Izmir Democracy University Health Sciences Journal, 2019;2(2), 114-117.
6. Al-Aska AK. Gastrointestinal manifestations of brucellosis in Saudi Arabian patients. Trop Gastroenterol 1989;10:217-9.
7. Aziz S, Al-Anazi AR, Al-Aska AI. A review of gastrointestinal manifestations of Brucellosis. Saudi J Gastroenterol. 2005;11(1):20-27. https://doi.org/10.4103/1319-3767.33333
8. Pirinçcioğlu A, Konca Ç, Fidan M, Karabiberoğlu S, Tutanç M. Çocukluk çağı brusellozunda bilateral sakroileit: olgu sunumu. Mustafa Kemal Üniversitesi Tıp Dergisi, 2010;1(2), 29-32.

9. Alkan Çeviker S, Elmaslar Mert HT, Gedik MA. Akut Kolesistit ile Başvuran Atipik Bruselloz Olgusu. Sakarya Tıp Dergisi. 2019;9(4):702-705. https://doi.org/10.31832/smj.564795
10. White CS. Cholecystitis as a complication of brucellosis: report of a case. Med Ann DC 1934;12:60-2.
11. Mettier SR, Kerr WJ. Hepatitis and cholecystitis in the course of Brucella infection. Report of a case. Arch Intern Med 1934;54:702-9. https://doi.org/10.1001/archinte.1934.00160170045004
12. Hewlett JS, Ernstene AC. Brucella abortus infection of the gallbladder treated with streptomycin. Report of a case. Cleve Clin Q 1947;24:258-63. https://doi.org/10.3949/ccjm.14.4.258
13. Hariz A, Beji I, Hamdi MS, Cherif E. Brucellosis, an uncommon cause of acute acalculous cholecystitis: two new cases and concise review. BMJ Case Reports CP, 2019;12(9), e229616. https://doi.org/10.1136/bcr-2019-229616
14. Pappas G, Papadimitriou P, Akritidis N, Christou L, Tsianos EV. The new global map of human brucellosis. Lancet Infect Dis. 2006;Feb;6(2):91-99. https://doi.org/10.1016/S1473-3099(06)70382-6
15. Wang XH, Jiang H. Global prevalence of human brucellosis. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41(10):1717-1722. https://doi.org/10.3760/cma.j.cn112338-20191022-00751
16. WHO/CDS/EPR/2006.7. Brucellosis in Humans and Animals. Geneva: World Health Organization, 2006.
17. Franco MP, Mulder M, Gilman RH, Smits HL. Human brucellosis. Lancet Infect Dis 2007;7:775-786. https://doi.org/10.1016/S1473-3099(07)70286-4