Acute acalculous cholecystitis as the initial presentation of primary Epstein-Barr virus infection

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Abstract

The case of a 13-year-old girl with primary Epstein-Barr virus (EBV) infection and concomitant cholestatic hepatitis, which initially presented as acute acalculous cholecystitis (AAC), is described. The diagnosis of AAC was documented by clinical and ultrasonographic criteria, whereas acute EBV infection was confirmed serologically. AAC may develop during the course of acute EBV infection, especially in patients with cholestatic hepatitis.

Section snippets

Case report

A 13-year-old girl was admitted to our hospital with a 5-day history of fever and chills, malaise, vomiting, and abdominal pain. She had no significant medical history, and her immunizations were up-to-date.

She was a well-developed white adolescent girl who appeared pale, fatigued, and jaundiced. Vital signs upon admission were as follows: temperature, 39.6°C; heart rate, 96 beats per minute; respiratory rate, 20/min; and blood pressure, 120/65 mm Hg. Scleral icterus, mild pharyngeal erythema,

Discussion

Gallbladder disease is rare in the pediatric age group. Acute acalculous cholecystitis is an inflammatory process of the gallbladder in the absence of gallstone, which accounts for 30% to 50% of the pediatric cholecystitis cases [4]. Most cases of AAC in children occur during the course of infectious diseases. Reported pathogens include streptococci (groups A and groups B), Gram-negative organisms, particularly Salmonella and Leptospira interrogans, hepatitis A virus, and parasites [5], [6], [7]

References (14)

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