Acute acalculous cholecystitis secondary to hepatitis A infection.

Abstract

Acute acalculous cholecystitis (AAC) of infectious origin represents a small percentage of all cases of cholecystitis. According to the literature, the most common pathogens include Salmonella typhii and Epstein-Barr virus (EBV). However, AAC has also been described as a rare complication in the context of other viral hepatitis infections, with only a few reported cases attributed to hepatitis A virus (HAV) infection. We present the case of a patient with AAC secondary to HAV infection, which resolved favorably with conservative management. We report the case of a 29-year-old male presenting with jaundice, abdominal pain, and fever lasting three days. Laboratory results revealed elevated transaminase levels with a cholestatic pattern and hyperbilirubinemia, predominantly direct bilirubin. Abdominal ultrasound showed a gallbladder with a thickened, heterogeneous, poorly defined, and disorganized wall, along with multiple enlarged perihilar lymph nodes and a positive Murphy's sign. Serological testing for hepatopathy revealed positive IgM antibodies for HAV, confirming the diagnosis of hepatitis A. Seven days later, follow-up testing demonstrated normalization of both laboratory parameters and ultrasound findings following resolution of the viral illness.