Acute acalculous cholecystitis in dengue fever.
OBJECTIVE
To investigate the frequency, clinical features, management and outcome of acute acalculous cholecystitis in dengue fever patients.


METHODS
Forty patients were admitted with the diagnosis of dengue fever, according to the clinical manifestations and laboratory investigations. The diagnosis of dengue fever was confirmed by a positive IgM antibody test result for a late or convalescent phase blood specimen. The diagnosis of acute acalculous cholecystitis was made according to clinical features and sonographic findings. Liver function tests, complete blood counts were determined. Abdominal ultrasound was performed with a real time scanner in patients with abdominal pain and abnormal results on liver function tests.


RESULTS
Eleven out of 40 patients of dengue fever (27.5%) had complication of acute acalculous cholecystitis. There were 8 males and 3 females. The mean and standard deviation from the onset of fever to hospital visit was 3.3 +/- 0.8 days (range 2-5 days). The mean white cell counts was 4154 +/- 1577.5 cmm. The mean platelet counts were 26,727 +/- 10460.3 cmm on presentation in hospital. The mean SGPT level was 148.5 +/- 190.17 mg/dl. Mean alkaline phosphatase was 398 +/- 214.8 mg/dl. On sonography all had thickened gall bladder. The mean gall bladder wall thickness was 5.2 +/- 1.3 mm. Three patients had ascites and one patient had pleural effusion.


CONCLUSIONS
Acute acalculous cholecystitis was seen in a significant proportion of patients with dengue fever. All patients improved with good hydration and correction of thrombocytopenia. Based on these observations it is suggested that close observation and initial treatment of thrombocytopenia is mandatory.
Bhatty
Shaheen
S
Medical Unit 1, Civil Hospital Karachi, Dow University of Health Sciences, Karachi.
Shaikh
Niaz Ahmed
NA
Fatima
Mariam
M
Sumbhuani
Aneel Kumar
AK
D042101:Acalculous Cholecystitis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D000208:Acute Disease; D000410:Alanine Transaminase / Q000097:blood; D001772:Blood Cell Count; D003715:Dengue / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D005260:Female; D006801:Humans; D007902:Length of Stay; D008111:Liver Function Tests; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D011379:Prognosis; D012307:Risk Factors; D013921:Thrombocytopenia / Q000453:epidemiology / Q000209:etiology; D016896:Treatment Outcome; D014463:Ultrasonography
D000410:Alanine Transaminase