title: Acute acalculous cholecystitis associated with Q fever: report of seven cases and review of the literature.
abstract: Q fever is a worldwide-occurring zoonosis caused by Coxiella burnetii. There are various clinical manifestations of acute Q fever, of which acute cholecystitis is a very rare clinical presentation. This study reports seven cases of acute cholecystitis associated with Coxiella burnetii and reviews two other cases from the literature. All patients were admitted to hospital for fever and abdominal pain in the right upper quadrant. Abdominal echography showed a distended gallbladder with biliary sludge without concrements in eight cases and with a single stone in one case. Diagnosis was made by specific serological investigation (microimmunofluorescence assay) for Coxiella burnetii. All nine patients were cured, six after laparoscopic cholecystectomy and three with antibiotics only. Histological examination of the gallbladders showed inflammation in five cases, although Coxiella burnetii was not detected by immunohistochemistry. The results show that laboratory investigations in patients admitted to hospital for symptoms consistent with acute acalculous cholecystitis should include a systematic search for Coxiella burnetii.
authors.affiliation: Unité des Rickettsies CNRS UMR-A 6020, IFR 48, Faculté de Médecine, Université de la Méditerranée, 27 Boulevard Jean Moulin, 13385, Marseille Cedex 05, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Rolain
authors.forename: H
authors.initials: H
authors.lastname: Lepidi
authors.forename: J R
authors.initials: JR
authors.lastname: Harlé
authors.forename: T
authors.initials: T
authors.lastname: Allegre
authors.forename: E D
authors.initials: ED
authors.lastname: Dorval
authors.forename: Z
authors.initials: Z
authors.lastname: Khayat
authors.forename: D
authors.initials: D
authors.lastname: Raoult
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002764:Cholecystitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D016997:Coxiella burnetii / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011778:Q Fever / Q000150:complications*
chemical_list: D000900:Anti-Bacterial Agents