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Acute acalculous cholecystitis

Case contributed by Paul Adamoli
Diagnosis almost certain

Presentation

Hospitalized for fever, severe neck lymphadenomegaly and mild hepatosplenomegaly. Blood panels show severe increase of anti-EBV IgM and moderate increase of the anti-Cytomegalovirus IgM.

Patient Data

Age: 4 years
Gender: Male
ultrasound

Abdomen ultrasound confirms mild hepatosplemegaly. The gallbladder presents a remarkable wall thickening, mucosal swelling with anechoic content.

ultrasound

The transverse scan after 48 hours shows more increased wall thickness.

Case Discussion

This case illustrates features of acute acalculous cholecystitis. It is an infrequent manifestation of several viral infections. In our case, it is suggested to be a complication of primary Epstein-Barr viral infection.

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