Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- 43 Acute viral hepatitis
- 44 Chronic hepatitis
- 45 Biliary infection: cholecystitis and cholangitis
- 46 Pyogenic liver abscess
- 47 Infectious complications of acute pancreatitis
- 48 Esophageal infections
- 49 Gastroenteritis
- 50 Food poisoning
- 51 Antibiotic-associated diarrhea
- 52 Sexually transmitted enteric infections
- 53 Acute appendicitis
- 54 Diverticulitis
- 55 Abdominal abscess
- 56 Splenic abscess
- 57 Peritonitis
- 58 Whipple’s disease
- Part VIII Clinical syndromes: genitourinary tract
- Part IX Clinical syndromes: musculoskeletal system
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- Part XII HIV
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- Part XV Prevention of infection
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
45 - Biliary infection: cholecystitis and cholangitis
from Part VII - Clinical syndromes: gastrointestinal tract, liver, and abdomen
Published online by Cambridge University Press: 05 April 2015
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- 43 Acute viral hepatitis
- 44 Chronic hepatitis
- 45 Biliary infection: cholecystitis and cholangitis
- 46 Pyogenic liver abscess
- 47 Infectious complications of acute pancreatitis
- 48 Esophageal infections
- 49 Gastroenteritis
- 50 Food poisoning
- 51 Antibiotic-associated diarrhea
- 52 Sexually transmitted enteric infections
- 53 Acute appendicitis
- 54 Diverticulitis
- 55 Abdominal abscess
- 56 Splenic abscess
- 57 Peritonitis
- 58 Whipple’s disease
- Part VIII Clinical syndromes: genitourinary tract
- Part IX Clinical syndromes: musculoskeletal system
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- Part XII HIV
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- Part XV Prevention of infection
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
Summary
This chapter discusses the pathogenesis, diagnosis, and treatment of infections of the gallbladder and bile ducts. Bacterial disorders of the biliary tract range from simple colonization of bile with bacteria to serious, life-threatening problems requiring prompt diagnosis and treatment.
Acute cholecystitis
Acute cholecystitis is a common disorder manifest as acute inflammation of the gallbladder. Ninety-eight percent of episodes exhibit cystic duct obstruction, usually by a gallstone impacted in the gallbladder neck. Cystic duct obstruction results in nonvisualization of the gallbladder on technetium radionucleotide cholecintography (HIDA) scan. In 2% to 5% of cases, termed acute acalculous cholecystitis, gallstones are not present. Acute acalculous cholecystitis is most often found in debilitated or critically ill patients who have not been fed by mouth for extended periods of time, but acalculous cholecystitis also occurs in normal individuals. It is believed that stasis of bile in the gallbladder lumen leads to gallbladder wall inflammation in both calculous and acalculous cholecystitis. Bacteria play a secondary role as superinfection of bile with bacteria, and eventually gallbladder wall compromise, are later events (Figure 45.1). If unchecked, the process progresses to complicated cholecystitis with gangrene or perforation of the gallbladder. It is imperative that acute cholecystitis be diagnosed and effectively treated before life-threatening complications of acute cholecystitis ensue.
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- Chapter
- Information
- Clinical Infectious Disease , pp. 308 - 313Publisher: Cambridge University PressPrint publication year: 2015