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Author(s): Abreu, C.
Santos, L.
Poínhos, Rui
Sarmento, A.
Title: Acute acalculous cholecystitis in malaria: A review of seven cases from an adult cohort
Issue Date: 2013
Abstract: Purpose and methods Acute acalculous cholecystitis (AAC) is an uncommon condition related to serious clinical conditions, such as surgery, trauma, burn injuries and sepsis. The diagnosis of AAC remains challenging to make, since it generally occurs as a secondary event in acutely ill patients with another disease. Imaging evaluation is crucial, and welknown criteria are accepted for the diagnosis. To our knowledge, only case reports of AAC related to 12 malaria adult patients have been published. In this series, seven cases of AAC from a cohort of 42 adult patients with severeimported falciparum malaria [according to the WorldHealth Organization (WHO) criteria] are presented. Theaim is to report the cases and look for malaria conditions thatmay affect the incidence of this unusual malaria complication.Results Ultrasonography revealed gallbladder with wallthickening in all patients, plus other(s) major criteria. Eachpatient presented five to nine WHO severe malaria criteria:all had hyperparasitaemia and hyperbilirubinaemia. All patients developed renal failure, six pulmonary oedema/acute respiratory distress syndrome (ARDS) (five weremechanically ventilated) and five shock. Treatment wasnon-operative in five patients, cutaneous cholecystostomywas done in two and the outcome was favourable in all.ConclusionsPatients with AAC have significantly morecommonly five or more criteria of severe malaria: renalinsufficiency, pulmonary oedema/ARDS, parasitaemiahigher than 30 %, nosocomial infection and a prolongedintensive care unit (ICU) stay. Increased awareness for thisunusual and potentially severe complication of malaria isneeded.
Subject: Ciências da Saúde, Ciências da saúde
Health sciences, Health sciences
Scientific areas: Ciências médicas e da saúde::Ciências da saúde
Medical and Health sciences::Health sciences
Document Type: Artigo em Revista Científica Internacional
Rights: restrictedAccess
Appears in Collections:FCNAUP - Artigo em Revista Científica Internacional

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