Gallbladder - AIDS related cholecystitis

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Gallbladder

Cholecystitis

AIDS related cholecystitis

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 11 February 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● 40% have opportunistic infections (cryptosporidia, CMV, microsporidia), which are usually also present at other sites
● Usually no opportunistic infections if HIV+ but not classified as AIDS
● Often acalculous

Specific infections
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CMV:
● Usually erosions and deep ulcers
● Marked microscopic changes

Cryptosporidia:
● Small, round, basophilic organisms at luminal epithelial border

Microsporidia:
● Enterocytozoon bieneusi, less often Septata intestinalis
● S. intestinalis within epithelium and lamina propria
● Can identify with H&E stain, but often missed

Case reports
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● 31 year old woman with acalculous cholecystitis and sclerosing cholangiopathy (Br J Radiol 2009;82:699)
● 35 year old man with acalculous cholecystitis due to Cyclospora cayetanensis (Clin Infect Dis 2001;33:E140)
● 37 year old woman of Tanzanian origin presented with symptoms of cholecystitis, sepsis and oral candidiasis (BMJ Case Rep. 2011 Mar 1;2011. pii: bcr0820103292. doi: 10.1136/bcr.08.2010.3292.)
● Cholecystitis as the initial manifestation of disseminated cryptococcosis (AIDS 2007;21:2111)

Micro images
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Cryptosoridium parvum

Cyclospora

End of Gallbladder > Cholecystitis > AIDS related cholecystitis

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