Actinomycosis of the gallbladder is rare and caused by Actinomyces spp. bacteria. It may present as biliary colic, cholecystitis or pancreatitis. It is a mimic of gallbladder carcinoma.
On this page:
Epidemiology
Actinomycosis is endemic worldwide. It has no predilection for age, gender, ethnicity or climate 4.
Risk factors
Predisposing conditions for actinomycosis include 2:
- steroids
- diabetes mellitus
- previous surgery
- malignancy
Clinical presentation
- right upper quadrant pain
- nausea and vomiting
- fever
- positive Murphy sign
- palpable mass
- biliary colic
- cholecystitis
- pancreatitis
Laboratory tests
- leukocytosis
- elevated erythrocyte sedimentation rate (ESR)
- elevated serum alkaline phosphatase
- elevated bilirubin
- elevated serum amylase 5
Pathology
The Actinomyces are a genus of Gram positive anaerobic filamentous bacteria, which may be normally present in the oral cavity, colon, and urogenital tract 4.
Actinomycosis is a chronic suppurative granulomatous infection depicted by the formation of numerous abscesses.
Radiographic features
Findings are non-specific and commonly include 1-4:
- gallbladder wall edema
- gallstones
- diffuse mural thickening of gallbladder
- intraluminal mass lesion
Treatment and prognosis
Cholecystectomy with extended antibiotics for as long as one year is advised for patients with all types of actinomycosis to avoid disease recurrence. Therapy of choice is short course high dose IV, followed by oral, penicillin 2,5.
Drainage may also be required if abscesses are present.
Unable to process the form. Check for errors and try again.