Abstract
IntroductionAcalculous cholecystitis has been shown to occur in the context of malarial infection with Plasmodium vivax and Plasmodium falciparum and requires prompt diagnosis and treatment to prevent complications. To the best of our knowledge this is the first reported case of the disease occurring in a patient infected with Plasmodium malariae.Case presentationWe report the first case of acalculous cholecystitis associated with Plasmodium malariae in a 59-year-old male Nepalese ex-Gurkha soldier. He presented with fever and vomiting and later developed right upper quadrant pain. Abdominal ultrasound and computed tomography scans confirmed acalculous cholecystitis for which he was treated medically with chloroquine, gentamicin and metronidazole. He made a full recovery.ConclusionsPhysicians should be aware that in addition to Plasmodium vivax and Plasmodium falciparum infections, acalculous cholecystitis can occur in the context of Plasmodium malariae infection. Mechanisms for this are discussed but further studies are needed to establish the etiology of this association.
Highlights
Acalculous cholecystitis has been shown to occur in the context of malarial infection with Plasmodium vivax and Plasmodium falciparum and requires prompt diagnosis and treatment to prevent complications
Physicians should be aware that in addition to Plasmodium vivax and Plasmodium falciparum infections, acalculous cholecystitis can occur in the context of Plasmodium malariae infection
Of the five Plasmodium parasites responsible for the disease in humans (Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, Plasmodium ovale and Plasmodium knowlesi), only P. falciparum and P. vivax have so far been associated with AAC
Summary
In addition to P. falciparum and P. vivax infection, AAC should be considered a complication of P. malariae infection. The mechanisms underlying this are unclear and require further study. In any case of malaria, regardless of the species involved, deranged liver function tests and RUQ pain should prompt investigations to exclude AAC in order to allow timely treatment if required. Consent Written informed consent was obtained from the patient for publication of this case report. Competing interests The authors declare that they have no competing interests. ML was the consultant responsible for the care of the patient and provided the initial concept for the case report, as well as assistance in editing. All authors read and approved the final manuscript
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