Abstract
Acute acalculous cholecystitis is inflammation of the gallbladder without any evidence of gallstones. Although acalculous cholecystitis is less common than its calculous counterpart, it can be fatal if not treated. It is essential to rule out the cause of acalculous cholecystitis to aid in the treatment and management of the patient. We present a case of acalculous cholecystitis wherein a comprehensive workup found the etiology to be viral. Albeit rare, hepatitis A and cytomegalovirus can be causes of acute cholecystitis. Both viruses were observed simultaneously in this patient, proving it to be a unique case. This early diagnosis allowed conservative management of the patient, sparing him from unnecessary surgical intervention.
Highlights
Inflammation of the gallbladder without any evidence of gallstones is known as acute acalculous cholecystitis
While hepatic and extrahepatic complications have been recognized for Hepatitis A virus (HAV), acute acalculous cholecystitis is a rare complication of acute viral hepatitis [1]
We report a case of acute acalculous cholecystitis due to acute HAV infection with concurrent acute CMV infection
Summary
Inflammation of the gallbladder without any evidence of gallstones is known as acute acalculous cholecystitis. While hepatic and extrahepatic complications have been recognized for HAV, acute acalculous cholecystitis is a rare complication of acute viral hepatitis [1]. Rare is acute cytomegalovirus (CMV) infection as an etiology for acute acalculous cholecystitis [2]. A 37-year-old man with a five-year history of IV heroin abuse (sober for 10-years) presented with worsening epigastric pain, loss of appetite, nausea, and dark urine of one week duration. He did not have a primary care physician, and no other medical history was known. He was subsequently discharged to the rehabilitation program on hospital day 5 in stable clinical condition
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