English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

It is rare for acalculous cholecystitis to present with symptoms outside the abdomen; hence, making its diagnosis can be a challenge. We report a case of a 77-year-old male, with a relevant past medical history of left knee arthroplasty two years prior, who presented with left knee pain and swelling. Cultures from the arthrocentesis grew  Clostridium perfringens , which led to a search for the source of infection. The right upper quadrant (RUQ) ultrasound (US) showed an enlarged gallbladder filled with sludge, but no cholelithiasis or secondary ultrasound findings were present to suggest acute cholecystitis. A computed tomography (CT) scan showed a distended gallbladder with diffuse gallbladder wall thickening and no stone but with suspicion for acalculous cholecystitis. A subsequent hepatobiliary (HIDA) scan confirmed the diagnosis of acalculous cholecystitis. Subsequently, the patient had a biliary drain placed. Bile cultures grew gram-positive rods consistent with  Clostridium perfringens , confirming the source. With regards to the septic prosthetic joint, the patient underwent irrigation and debridement with polyethylene exchange without replacement of the prosthesis. The patient was also treated with six weeks of intravenous (IV) ertapenem (1 gram daily) and 12 months of moxifloxacin (400 mg daily). He had a cholecystectomy later and his symptoms were completely resolved.

Acalculous Cholecystitis Presenting as a Septic Joint: A Case Report