title: Mycobacterium avium complex-associated cholecystitis in AIDS patient: a case description and review of literature.
abstract: AIDS-related cholangiopathy was common in patients with AIDS prior to the advent of highly active antiretroviral therapy. Mycobacterium avium complex (MAC) is the most common opportunistic bacterial infection seen in AIDS patients and one of many opportunistic pathogens implicated in AIDS cholangiopathy. We describe a case of acute cholecystitis secondary to MAC in a patient with likely AIDS cholangiopathy. The patient, a 37-year-old Hispanic woman with CD4+cell count of 10 cells/mm3who was previously diagnosed with disseminated MAC, presented with a eight days of diffuse abdominal pain and anorexia. Radiologic imaging suggested acute cholecystitis, so the patient underwent open cholecystectomy. Pathology staining of the gall bladder wall revealed acid-fast bacilli consistent with MAC. The patient had been receiving appropriate therapy as an outpatient for MAC with presumed reliable adherence, but we suggest her burden of disease was high due to her severe immunosuppressive state. A thorough review of the literature showed that there are many infectious and non-infectious aetiologies for AIDS-associated cholangiopathy. Acute cholecystitis can develop in the setting of AIDS cholangiopathy, potentially secondary to the opportunistic infection that initially caused the cholangiopathy. MAC-related gallbladder disease needs to be considered in patients with advanced AIDS who present with evidence of acute cholecystitis.
authors.affiliation: Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Firas
authors.initials: F
authors.lastname: El Chaer
authors.affiliation: Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Nadine
authors.initials: N
authors.lastname: Harris
authors.affiliation: Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.|Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Hana
authors.initials: H
authors.lastname: El Sahly
authors.affiliation: Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Vagish
authors.initials: V
authors.lastname: Hemmige
authors.affiliation: Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Elvia
authors.initials: E
authors.lastname: Martinez Blanco
authors.affiliation: Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX, USA woccolbu@bcm.edu.
authors.forename: Laila
authors.initials: L
authors.lastname: Woc-Colburn
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D002764:Cholecystitis / Q000150:complications*; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D006801:Humans; D015269:Mycobacterium avium Complex / Q000187:drug effects / Q000302:isolation & purification*; D015270:Mycobacterium avium-intracellulare Infection / Q000150:complications* / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: AIDS cholangiopathy; HIV/AIDS; Mycobacterium avium complex cholecystitis