title: Acute acalculous cholecystitis and pancreatitis in a patient with concomitant leptospirosis and scrub typhus.
abstract: Concomitant leptospirosis and scrub typhus is rare. The spectrum of clinical severity for both scrub typhus and leptospirosis ranges from mild to fatal. Acute pancreatitis and cholecystitis are infrequent complications in adult patients with either leptospirosis or scrub typhus. We report a case of leptospirosis and scrub typhus coinfection in a 41-year-old man presenting with acute acalculous cholecystitis, pancreatitis and acute renal failure. Abdominal computed tomography revealed edematous change of the gallbladder without intrahepatic or pancreatic lesions. The patient was successfully treated with doxycycline and ceftriaxone, and supportive management.
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Ning-Chi
authors.initials: NC
authors.lastname: Wang
authors.forename: Yuen-Hua
authors.initials: YH
authors.lastname: Ni
authors.forename: Ming-Yieh
authors.initials: MY
authors.lastname: Peng
authors.forename: Feng-Yee
authors.initials: FY
authors.lastname: Chang
mesh_terms: D042101:Acalculous Cholecystitis / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D002443:Ceftriaxone / Q000627:therapeutic use; D041881:Cholecystitis, Acute / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D004318:Doxycycline / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D007921:Leptospira interrogans / Q000276:immunology; D007922:Leptospirosis / Q000150:complications* / Q000175:diagnosis; D008889:Military Personnel; D012285:Orientia tsutsugamushi / Q000276:immunology; D010195:Pancreatitis / Q000150:complications*; D051437:Renal Insufficiency / Q000209:etiology; D012612:Scrub Typhus / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D002443:Ceftriaxone; D004318:Doxycycline