免疫功能正常患者的慢性胆囊炎合并贝氏等孢球虫感染
Chronic cholecystitis with Cystoisospora belli in an immunocompetent patient.
作者信息
Takahashi Hideo, Falk Gavin A, Cruise Michael, Morris-Stiff Gareth
机构信息
Department of HPB Surgery, Cleveland Clinic, Cleveland, Ohio, USA.
Department of Anatomic Pathology, Cleveland Clinic, Cleveland, Ohio, USA.
出版信息
BMJ Case Rep. 2015 Jun 11;2015:bcr2015209966. doi: 10.1136/bcr-2015-209966.
A 47-year-old woman presented with a history of vague abdominal pain for several years, which worsened over the past 2 months, with pain more prominent in the right upper quadrant. She also had a history of peptic ulcer disease. The ultrasound scan of right upper quadrant revealed normal gallbladder and oesophagogastroduodenoscopy was unremarkable. A (99m)technetium labelled hepato iminodiacetic acid (HIDA) scan with cholecystokinin provocation demonstrated a decreased gallbladder ejection fraction (EF) of 32%. On this basis, the patient was diagnosed with biliary dyskinesia and underwent an elective laparoscopic cholecystectomy. Histopathological analysis revealed chronic cholecystitis with Cystoisospora belli identified in the gallbladder wall. Cystoisospora has been identified to cause an opportunistic acalculous cholecystitis among immunocompromised hosts, especially those with AIDS. This is the first case report of chronic cholecystitis due to C. belli in an immunocompetent patient.
一名47岁女性，有多年腹部隐痛病史，近2个月病情加重，右上腹疼痛更为明显。她还有消化性溃疡病史。右上腹超声扫描显示胆囊正常，食管胃十二指肠镜检查无异常。静脉注射促胆囊收缩素后行锝（99m）标记的亚氨基二乙酸（HIDA）扫描，结果显示胆囊排空分数（EF）降低，为32%。基于此，该患者被诊断为胆囊运动障碍，并接受了择期腹腔镜胆囊切除术。组织病理学分析显示为慢性胆囊炎，在胆囊壁中发现了贝氏等孢球虫。已确定等孢球虫可在免疫功能低下的宿主中引起机会性无结石性胆囊炎，尤其是艾滋病患者。这是第一例关于免疫功能正常患者因贝氏等孢球虫引起慢性胆囊炎的病例报告。
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