Acute cholecystitis associated with pneumococcal bacteremia and purpura fulminans

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2007 (EN)
Acute cholecystitis associated with pneumococcal bacteremia and purpura fulminans (EN)

D. Xanthis,² G. Thomopoulos, N. Archontoulis,
I. Pavleas,² S. Georgiou,² K. Rigas,, T. Megas,1 A.M. Mega,² P. Vernikos,

The case of a previously healthy 47-year-old woman who was admitted to our hospital with symptoms of acute abdomen, septic shock and cutaneus rash is presented. The U.S. revealed cholelithiasis, cholecystitis and pericholecystitis and the patient was immediately treated by surgical removal of the gall bladder. In the blood culture a penicillin-susceptible strain of Streptococcus pneumoniae (Pneumonococcus) was isolated. After surgery the patient was transferred to I.C.U. where she presented M.O.D.S. (Multiple Organs Failure Syndrome) and D.I.C. (Disseminated Intravascular Coagulation). She died two days later despite pharmacologic therapy and mechanical support, of respiratory and renal failure. To our knowledge, this is a very rare case of acute cholecystitis associated with pneumococcal bacteremia (we found only five similar cases in the literature). Pneumococcal septic shock is usually associated with immunosuppression or asplenism (surgical or functional). In our patient functional hyposplenism was diagnosed by identification of Howell- Jolly bodies in the peripheral blood smear. Key words: Pneumococcal bacteremia, S. pneumoniae bacteremia, purpura fulminans, acute cholecystitis. (EN)




Hellenic Society of Gastroenterology (EN)

Annals of Gastroenterology; Volume 18, No 3 (2005) (EN)

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