Volume 68, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Dengue fever (DF) with acute acalculous cholecystitis is rarely reported. To investigate the incidence, treatment, and prognosis of acute acalculous cholecystitis in DF patients, we retrospectively studied 10 patients with DF and acute acalculous cholecystitis. From October 2001 to July 2002, 131 patients were diagnosed with DF. Ten of 131 DF patients (7.63%) had complications of acute acalculous cholecystitis. Two patients underwent cholecystectomy and one underwent percutaneous transhepatic gallbladder drainage due to poor resolution of acute acalculous cholecystitis. We found acute acalculous cholecystitis in a small proportion of patients with DF. In our experience, closely monitoring vital signs to avoid shock and correct thrombocytopenia to avoid bleeding could be adequate for most patients. In some cases, surgical treatment may be needed for DF fever patients with complications of diffuse peritonitis.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Halstead SB, 1980. Dengue hemorrhagic fever. a public health problem and a field for research. Bull World Health Organ 58 : 1–21. [Google Scholar]
  2. Kalayanarooj S, Vaughn DW, Nimmannitya S, Green S, Suntayakorn S, Kunentrasai N, Viramitrachai W, Ratanachu-eke S, Kiatpolpoj S, Innis BL, Rothman AL, Nisalak A, Ennis FA, 1997. Early clinical and laboratory indicators of acute dengue illness. J Infect Dis 176 : 313–321. [Google Scholar]
  3. Cobra C, Rigau-Perez JG, Kuno G, Vorndam V, 1995. Symptoms of dengue fever in relation to host immunologic response and virus serotype, Puerto Rico, 1990–1991. Am J Epidemiol 142 : 1204–1211. [Google Scholar]
  4. Engel JM, Deitch EA, Sikkema W, 1980. Gall bladder wall thickness: sonographic accuracy and relation to disease. Am J Roentgenol 134 : 907–909. [Google Scholar]
  5. Bilhartz LE, 1998. Acute acalculous cholecystitis, adenomyomatosis, cholesterolosis, and polyps of the gallbladder. Feldman M, Sleisenger MH, Scharschmidt BF, eds. Gastrointestinal and Liver Disease. Sixth edition. Philadelphia: W. B. Saunders, 993–1005.
  6. Tai DI, Kuo CH, Lan CK, Chiou SS, Chang-Chien CS, 1990. Abdominal ultrasonographic features in dengue fever. Chin J Gastroenterol 7 : 182–187. [Google Scholar]
  7. Wang LY, Chang WY, Lu SN, Chen TP, 1990. Sequential changes of serum transaminase and abdominal sonography in patients with suspected dengue fever. Kaohsiung J Med Sci 6 : 483–489. [Google Scholar]
  8. Thulkar S, Sharma S, Srivastava DN, Sharma SK, Berry M, Pandey RM, 2000. Sonographic findings in grade III dengue hemorrhagic fever in adults. J Clin Ultrasound 28 : 34–37. [Google Scholar]
  9. George R, Liam CK, Chua CT, Lam SK, Pang T, Geethan R, Foo LS, 1988. Unusual clinical manifestations of dengue virus infection. Southeast Asian J Trop Med Public Health 19 : 585–590. [Google Scholar]
  10. Sumarmo, Wulur H, Jahja E, Gubler DJ, Suharyono W, Sorensen K, 1983. Clinical observations on virologically confirmed fatal dengue infections in Jakarta, Indonesia. Bull World Health Organ 6 : 693–701. [Google Scholar]
  11. Nimmannitya S, Thisyakorn U, Hemsrichart V, 1987. Dengue haemorrhagic fever with unusual manifestations. Southeast Asian J Trop Med Public Health 18 : 398–406. [Google Scholar]
  12. Jusuf H, Sudjana P, Djumhana A, Abdurachman SA, 1998. DHF with complication of acute pancreatitis related hyperglycemia: a case report. Southeast Asian J Trop Med Public Health 29 : 367–369. [Google Scholar]
  13. Sood A, Midha V, Sood N, Kaushal V, 2000. Acalculous cholecystitis as an atypical presentation of dengue fever. Am J Gastroenterol 95 : 3316–3317. [Google Scholar]
  14. Van Troys H, Gras C, Coton T, Deparis X, Tolou H, Durand JP, 2000. Imported dengue hemorrhagic fever: description of 1 case presenting with signs of acute alithiastic cholecystitis. Med Trop (Mars) 60 : 278–280. [Google Scholar]
  15. Winkler AP, Gleich S, 1988. Acute acalculous cholecystitis caused by Salmonella typhi in an 11-year old. Pediatr Infect Dis J 7 : 125–128. [Google Scholar]
  16. Cappell MS, 1991. Hepatobiliary manifestations of the acquired immune deficiency syndrome. Am J Gastroenterol 86 : 1–15. [Google Scholar]
  17. Shapiro MJ, Luchtefeld WB, Kurzweil S, Kaminski DL, Durham RM, Mazuski JE, 1994. Acute acalculous cholecystitis in the critically ill. Am Surg 60 : 335–339. [Google Scholar]
  18. Hakala T, Nuutinen PJO, Roukonen ET, Alhava E, 1997. Microangiopathy in acute acalculous cholecystitis. Br J Surg 84 : 1249–1252. [Google Scholar]
  19. Savoca PE, Longo WE, Pasternak B, Gusberg RJ, 1990. Does visceral ischemia play a role in the pathogenesis of acute acalculous cholecystitis? J Clin Gastroenterol 12 : 33–36. [Google Scholar]
  20. Gubler DJ, Kuno G, Sather GE, Velez M, Oliver A, 1984. Mosquito cell cultures and specific monoclonal antibodies in surveillance for dengue virus. Am J Trop Med Hyg 33 : 158–165. [Google Scholar]
  21. Kuo CH, Tai DI, Chang-Chien CS, Lan CK, Chiou SS, Liaw YF, 1992. Liver biochemical tests and dengue fever. Am J Trop Med Hyg 47 : 265–270. [Google Scholar]
  22. Bhamarapravati N, Tuchinda P, Boonyapaknavik V, 1967. Pathology of Thailand haemorrhagic fever: a study of 100 autopsy cases. Ann Trop Med Parasitol 61 : 500–510. [Google Scholar]
  23. Setiawan MW, Samsi TK, Pool TN, Sugianto D, Wulur H, 1995. Gallbladder wall thickening in dengue hemorrhagic fever: an ultrasonographic study. J Clin Ultrasound 23 : 357–362. [Google Scholar]
  24. Boland GW, Lee MJ, Leung J, Mueller PR, 1994. Percutaneous cholecystostomy in critically ill patients: Early response and final outcome in 82 patients. Am J Roentgenol 163 : 339–342. [Google Scholar]
  25. Johnson LB, 1987. The importance of early diagnosis of acute acalculous cholecystitis. Surg Gynecol Obstet 164 : 197–203. [Google Scholar]

Data & Media loading...

  • Received : 21 Nov 2002
  • Accepted : 03 Mar 2003

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error