Acalculous cholecystitis in child with dengue: a case report

Abstract

Introduction: Dengue, a viral disease transmitted by Aedes aegypti, presents a wide clinical spectrum, ranging from asymptomatic cases to severe forms. Diagnosis is established through virological and serological tests, and it is crucial to differentiate it from other febrile illnesses. Acalculous cholecystitis emerges as an atypical manifestation associated with viruses such as dengue. The presence of abdominal pain and jaundice in dengue patients should raise suspicion for acalculous cholecystitis, and abdominal ultrasound is a useful method to help with diagnosis. Treatment tends to be conservative, reserving surgical interventions for severe complications, as it is usually self-limiting. Objective: To highlight the importance of investigating dengue infection in patients with acalculous cholecystitis, whose clinical presentation involves fever, cutaneous rash, jaundice and laboratory changes that may overlap with the common symptoms and findings of cholecystitis. Case description: Male patient, 4 years old, with clinical symptoms of maculopapular rash, fever, jaundice, acholic stools, and absence of gallstones on abdominal ultrasound. Serological tests were performed, showing positive IgM and PCR for dengue. The patient showed clinical and laboratory improvement during hospitalization with clinical treatment. Discussion: Acalculous cholecystitis is an atypical manifestation of dengue, typically self-limiting, that should be investigated in all patients with clinical presentation of abdominal pain, fever, cutaneous rash, and jaundice. The most appropriate approach is limited to clinical treatment, with surgery reserved for complications.