Acute Calculous Cholecystitis Associated with Leptospirosis: Which is the Emergency? A Case Report and Literature Review
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31. Juli 2024
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Artikel-Kategorie: Case Report
Online veröffentlicht: 31. Juli 2024
Seitenbereich: 271 - 278
Eingereicht: 11. März 2024
Akzeptiert: 12. Juli 2024
DOI: https://doi.org/10.2478/jccm-2024-0033
Schlüsselwörter
© 2024 Renata Moriczi et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Fig. 1.
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Fig. 4.
Changes in the patient’s laboratory parameters during hospitalization and six weeks after discharge
| Leucocyte (×103/μL) | 9.61 | 8.79 | 6.08 | 5.69 | 10.90 | 16.60 | 10.32 | 6.42 |
| Neutrophils (%) | 89.70 | 86.80 | 89 | 83 | 78 | 78.7 | 80.10 | 57.6 |
| Lymphocyte (%) | 6.61 | 6.63 | 0.27 | 9.40 | 0.98 | 8.34 | 1.10 | 34.3 |
| Hemoglobin (g/dL) | 14.10 | 12.4 | 10.40 | 10.80 | 12.60 | 14.00 | 12.3 | 14.2 |
| Hematocrit (%) | 42.60 | 36.4 | 30.10 | 31.90 | 37.80 | 41.50 | 34.7 | 44.6 |
| Thrombocyte (×103/μL) | 155.00 | 28.5 | 14.00 | 12.90 | 31.60 |
28.90 |
130.00 | 241.00 |
| AST (U/L) | 25.00 | 75.00 | 78.00 | 123.00 | 48.00 | 45.60 | 91.80 | 24.00 |
| ALT (U/L) | 22.00 | 47.00 | 50.00 | 88.00 | 29.00 | 15.00 | 43.30 | 74.00 |
| Total Bilirubin (mg/dL) | 1.37 | 5.01 | 5.44 | 5.43 | 9.67 | 7.38 | 5.89 | 0.79 |
| Direct Bilirubin (mg/dL) | - | 4.14 | - | - | - | 7.13 | 4.69 | 0.29 |
| C-Reactive Protein (mg/dL) | 143.20 | 291.40 | 252.30 | - | - | 139.00 | 71.60 | - |
| Urea (mg/dL) | 34.24 | 115.56 | 128.40 | 186.18 | 196.88 | 169.00 | 104.00 | 53.00 |
| Creatinine (mg/dL) | 1.26 | 4.68 | 5.51 | 6.56 | 5.65 | 3.55 | 1.61 | 1.27 |
| Calculated RFG (ml/min) | 60.35 | 13.31 | 11.03 | 9.02 | 10.71 | 17.26 | 42.99 | 57.00 |
| Amylase U/L | 50.00 | 89.00 | - | 432.00 | 232.00 | 453.00 | 439.00 | 74.00 |
Ten cases of acute acalculous cholecystitis as a complication of leptospirosis [2, 4, 8,9,10,11,12,13,14]
| Age | 19 | 46 | 35 | - | 30 | 64 | 55 | 40 | 83 | 45 |
| Sex | F | F | F | M | M | M | M | M | M | F |
| Country | Brazil | New Zealand | Netherlands | Netherlands | India | Greece | Spain | India | Malaysia | Turkey |
| Right hypochondrium or abdominal pain | Yes | Yes | Yes | Yes | yes | Yes | Yes | Yes | Yes | Yes |
| Jaundice | No | No | No | No | Yes | No | Yes | No | No | No |
| White blood cell number (×103/μL) | 7.7 | 2.0 | 10.90 | 4.4 | ND | 14.00 | 27.1 | 12.30 | 11.70 | 7.30 |
| Total bilirubin (mg/dL) | ND | ND | 48 | 34 | 2.1 | 3.1 | 12.4 | 3.9 | 0.91 | 0.3 |
| IgM titer | ND | ND | ND | ND | Unequivocally positive | Strongly positive | Positive | Positive | Positive | Positive |
| Thrombocytopenia (/μL) | Yes (145,000) | Yes (84,000) | No (121,000) | No (121,000) | Yes (65,000) | Yes (95,000) | Yes (57,000) | Yes (85,000) | No (169,000) | No (316,000) |
| Imaging modalities | Abdominal ultrasound and CT | Abdominal ultrasound and MRCP | Abdominal ultrasound | Abdominal ultrasound | Abdominal ultrasound | Abdominal ultrasound and CT | CT | Abdominal ultrasound | CT | Abdominal ultrasound |
| Imaging findings for acute cholecystitis | Yes | Yes | Yes | Yes | No | Yes | Yes | Yes | Yes | Yes |
| Gallbladder stones | AAC | AAC | AAC | AAC | AAC | AAC | AAC | ACC | ACC | ACC |
| Renal failure | No | No | No | No | No | Yes | Yes | Yes | Yes | No |
| Associated pancreatitis or pancreatic reaction | No | No | no | No | No | No | No | No | Yes | No |
| Treatment | Antibiotics | Antibiotics | Antibiotics | Antibiotics | Antibiotics and open cholecystectomy | Antibiotics and open cholecystectomy | Antibiotics | Antibiotics | Antibiotics | Antibiotics |
| Complications | Pneumonia, Pericarditis | - | Pneumonia | Pneumonia | - | Chronic renal failure | Multiorgan failure, death | - | - | - |