Septic acute cholecystitis.
BACKGROUND
Bacteremia occurs frequently in cholangitis, but the incidence of bacteremia in acute cholecystitis has not previously been examined.


METHODS
Seventy-eight cases (46 men and 32 women; mean age, 63 +/- 10 years) of acute cholecystitis with positive blood cultures were analyzed for clinical manifestation, bacteriology, and what consequences ensued. Seventy-eight non-bacteremic cholecystitis patients, matched for age and sex, served as the control group.


RESULTS
The prevalence of bacteremia in acute cholecystitis was 7.65% (78 of 1020). A single microorganism was isolated from the blood and bile in 87.2% and 27.3%, respectively. The commonest organisms were Escherichia coli and Klebsiella pneumoniae. The source of bacteremia could be identified from the infected bile in 80% of cases. Compared with the non-bacteremia group, significant increases in liver biochemical test results (aspartate and alanine aminotransferases and bilirubin, and so forth), more complications (acute renal failure and septic shock), and higher mortality (9.0%) were found in the bacteremic group.


CONCLUSIONS
Acute cholecystitis is not often complicated by bacteremia, but when bacteremia is present, morbidity and death more consistently ensue.
Kuo
C H
CH
Division of Gastroenterology, Chang Gung Memorial Hospital, Kaohsiung Hsien, Taiwan.
Changchien
C S
CS
Chen
J J
JJ
Tai
D I
DI
Chiou
S S
SS
Lee
C M
CM
D000208:Acute Disease; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D001646:Bile / Q000382:microbiology; D016022:Case-Control Studies; D002764:Cholecystitis / Q000453:epidemiology / Q000382:microbiology*; D004927:Escherichia coli Infections / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007710:Klebsiella Infections / Q000453:epidemiology*; D007711:Klebsiella pneumoniae; D008297:Male; D008875:Middle Aged; D015995:Prevalence