title: Acute acalculous cholecystitis: A rare presentation of typhoid fever in adults.
abstract: Adult typhoidal acute acalculous cholecystitis is rare with only 2 cases having been reported in the English literature. We present the case of a previously healthy 36-y-old female who suffered fever, chills, epigastralgia and progressive jaundice for 3 d, with acute acalculous cholecystitis subsequently diagnosed. In addition to antibiotic therapy with ceftriaxone, open cholecystectomy was performed. However, bile and blood culture both showed Salmonella typhi growth unexpectedly, and ileocolitis was revealed by colonoscopy. Careful tracing of the history of the patient recalled a history of travel to Indonesia. In adults without common risk factors for acalculous cholecystitis, a detailed history including travel to endemic areas and high index of suspicion for typhoidal acute acalculous cholecystitis are important, and appropriate antimicrobial therapy for covering Salmonella typhi should be considered.
authors.affiliation: Department of Infectious Disease, E-Da Hospital/I-Shou University, Kaohsiung County, Taiwan, Republic of China.
authors.forename: Chung-Hsu
authors.initials: CH
authors.lastname: Lai
authors.forename: Chun-Kai
authors.initials: CK
authors.lastname: Huang
authors.forename: Chuen
authors.initials: C
authors.lastname: Chin
authors.forename: Hsi-Hsun
authors.initials: HH
authors.lastname: Lin
authors.forename: Chih-Yu
authors.initials: CY
authors.lastname: Chi
authors.forename: Hsin-Pai
authors.initials: HP
authors.lastname: Chen
mesh_terms: D000208:Acute Disease; D000328:Adult; D002764:Cholecystitis / Q000209:etiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D012485:Salmonella typhi / Q000302:isolation & purification; D014435:Typhoid Fever / Q000150:complications* / Q000382:microbiology