Raptis Dimitrios, Aljareh Amr, Shah Usman, Tufail Muhammad Umer, Kolli Shiny Teja
Internal Medicine, New York City Health and Hospitals/Jacobi/North Central Bronx, The Bronx, USA.
Cureus. 2025 Apr 21;17(4):e82743. doi: 10.7759/cureus.82743. eCollection 2025 Apr.
Atypical presentations can confuse the clinical picture, especially in patients with comorbidities. Particularly, rare pathogens, such as can cause infections in immunocompromised patients or, sometimes, present as epidemic infections. We present a case of a female patient with a history of cryptogenic cirrhosis and poorly controlled diabetes, who developed acute calculous cholecystitis with positive bile cultures for , a rare, Gram-negative facultative anaerobic bacillus, usually associated with water sources and immunocompromised hosts. The patient also had positive titers for acute hepatitis A. This case is the first to our knowledge that reports -induced acute cholecystitis, along with concomitant acute hepatitis A positive serology. We aim to emphasize the importance of a broad differential diagnosis in such patients, early identification of rare pathogens, and the role of comprehensive clinical judgment in guiding treatment decisions.
非典型表现可能会使临床情况变得复杂，尤其是在患有合并症的患者中。特别是罕见病原体，如在免疫功能低下的患者中可引起感染，或有时表现为流行感染。我们报告一例有隐源性肝硬化病史且糖尿病控制不佳的女性患者，她发生了急性结石性胆囊炎，胆汁培养阳性，为一种罕见的革兰氏阴性兼性厌氧杆菌，通常与水源和免疫功能低下宿主有关。该患者甲型肝炎急性期滴度也呈阳性。据我们所知，该病例是首例报告由引起的急性胆囊炎以及同时存在甲型肝炎血清学阳性的病例。我们旨在强调在此类患者中进行广泛鉴别诊断、早期识别罕见病原体以及综合临床判断在指导治疗决策中的作用。
