Actinomycosis of the gallbladder: case report and review of the literature.
Actinomycosis of the gallbladder is very rare. Herein, we report the case of a 50-year-old man who presented with acute right hypochondrial pain, fever and rigors associated with positive Murphy's sign. Ultrasound showed that the gallbladder had multiple stones and an oedematous thick wall. The preoperative diagnosis was acute cholecystitis. The patient responded to conservative treatment with antibiotics. Laparoscopic cholecystectomy was performed 6 weeks later but was converted to open surgery because of dense adhesions to the duodenum and sealed duodenal perforation. Microscopic examination of the gallbladder showed moderate to severe inflammation with formation of microabscesses and numerous colonies of actinomycetes. We also review the literature on this rare disease. Although surgery is essential, prolonged postoperative antibiotic is required.
Hefny
Ashraf F
AF
Department of Surgery, Al-Ain Hospital, Al-Ain, United Arab Emirates.
Torab
Fawaz C
FC
Joshi
Sandhya
S
Sebastian
Michael
M
Abu-Zidan
Fikri M
FM
D000196:Actinomycosis / Q000175:diagnosis* / Q000188:drug therapy*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017081:Cholecystectomy, Laparoscopic / Q000379:methods; D041881:Cholecystitis, Acute / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D007813:Laparotomy; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D035583:Rare Diseases; D018570:Risk Assessment; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D008795:Metronidazole