Acute cholecystitis in AIDS patients: correlation of Tc-99m hepatobiliary scintigraphy with histopathologic laboratory findings and CD4 counts

Clinical Nuclear Medicine
A G CacciarelliH M Abdel-Dayem

Abstract

AIDS patients are susceptible to opportunistic gastrointestinal infections including ascending cholangitis and cholecystitis, especially if CD4 count is < 200. Incidence of acalculous cholecystitis has not been reported previously. We aim to evaluate the incidence of acalculous cholecystitis in AIDS patients and to identify causative organisms and mortality rate following cholecystectomy. We reviewed the files of 46 patients in order to meet the objectives of this study. CD4 counts were < 200 in 31 patients and > 200 in 15 patients. HIDA imaging was performed in 31 patients; in 8, the CD4 count was > 200 and all had calculous cholecystitis. The gallbladder was visualized in 3 patients for a sensitivity of 63% and no organisms were found in the gallbladder specimens. In 23 patients, the CD4 count was < 200; the gallbladder was visualized in 5 patients for a HIDA sensitivity of 78%; 16 (52%) had acalculous cholecystitis; and 15 had calculous cholecystitis. In acalculous cholecystitis, Cryptosporidium was found in six cases, cytomegalovirus (CMV) in six cases, and fungus, yeast, tuberculosis, and mycobacterium avium intracellular each in one case. The thirty day mortality rate was 18%; 5 of 28 who underwent open cholecystectomy di...Continue Reading

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Citations

Nov 30, 2000·Current Treatment Options in Gastroenterology·D T Walden
Apr 24, 2007·AJR. American Journal of Roentgenology·Shih-Feng LiuYung-Fa Lai
Aug 17, 2004·Acta chirurgica Iugoslavica·M Milicevic
May 9, 2009·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·M DrageC J Watson
Apr 8, 2017·Therapeutic Advances in Infectious Disease·Gautham KrishnamurthyRajinder Singh
Apr 9, 2001·Clinics in Liver Disease·E G Molina, K R Reddy

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