Mycobacterium avium complex-associated cholecystitis in AIDS patient: a case description and review of literature

Firas El Chaer, Nadine Harris, Hana El Sahly, Vagish S. Hemmige, Elvia Martinez Blanco, Laila Woc-Colburn

Research output: Contribution to journalArticle

Abstract

AIDS-related cholangiopathy was common in patients with AIDS prior to the advent of highly active antiretroviral therapy. Mycobacterium avium complex (MAC) is the most common opportunistic bacterial infection seen in AIDS patients and one of many opportunistic pathogens implicated in AIDS cholangiopathy. We describe a case of acute cholecystitis secondary to MAC in a patient with likely AIDS cholangiopathy. The patient, a 37-year-old Hispanic woman with CD4+ cell count of 10 cells/mm3 who was previously diagnosed with disseminated MAC, presented with a eight days of diffuse abdominal pain and anorexia. Radiologic imaging suggested acute cholecystitis, so the patient underwent open cholecystectomy. Pathology staining of the gall bladder wall revealed acid-fast bacilli consistent with MAC. The patient had been receiving appropriate therapy as an outpatient for MAC with presumed reliable adherence, but we suggest her burden of disease was high due to her severe immunosuppressive state. A thorough review of the literature showed that there are many infectious and non-infectious aetiologies for AIDS-associated cholangiopathy. Acute cholecystitis can develop in the setting of AIDS cholangiopathy, potentially secondary to the opportunistic infection that initially caused the cholangiopathy. MAC-related gallbladder disease needs to be considered in patients with advanced AIDS who present with evidence of acute cholecystitis.

Original languageEnglish (US)
Pages (from-to)1218-1222
Number of pages5
JournalInternational Journal of STD and AIDS
Volume27
Issue number13
DOIs
Publication statusPublished - Nov 1 2016
Externally publishedYes

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Keywords

  • AIDS cholangiopathy
  • HIV/AIDS
  • Mycobacterium avium complex cholecystitis

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Pharmacology (medical)
  • Infectious Diseases

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