Isolated gallbladder tuberculosis mimicking acute cholecystitis: A case report. 2020

Kai Siang Chan, and Vishal G Shelat, and Cher Heng Tan, and Yee Lin Tang, and Sameer P Junnarkar
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore.

BACKGROUND Isolated tuberculosis of the gallbladder is extremely rare due to its intrinsic resistance to tuberculous infections. There are reports of gallbladder tuberculosis mimicking cholecystitis or malignancy. However, these presentations were chronic. The diagnosis of gallbladder tuberculosis warrants the need for investigation of additional sites of inoculation and contact tracing of all tuberculosis contacts. Gallbladder tuberculosis is a rare entity but should be suspected in patients from endemic regions with risk factors such as underlying immunosuppression or history of tuberculosis. METHODS We present a case of gallbladder tuberculosis presenting as acute cholecystitis. A 44-year-old Filipino lady presented with a 11-d history of right hypochondrium and epigastric pain which worsened after meals with no significant past medical history. She underwent laparoscopic cholecystectomy on the presumptive diagnosis of acute cholecystitis and diagnosed as gallbladder tuberculosis after histopathological examination. The patient did not have features of pulmonary or systemic tuberculosis nor was she immunocompromised. She recovered uneventfully. She was subsequently discharged and followed-up at a hospital in her home country due to financial and social reasons. CONCLUSIONS Clinicians should have a high index of suspicion for patients in endemic regions presenting with cholecystitis.

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