Cholecystitis may be secondary to gallbladder involvement in visceral leishmaniasis. It is important to identify leishmaniasis since the patient requires workup and treatment.
Patient selection: cholecystitis, which may be acute, chronic or gangrenous
When to consider the diagnosis of leishmaniasis in a patient with cholecystitis:
(1) The patient has other evidence of visceral leishmaniasis or positive serologic tests.
(2) The person is immunosuppressed (HIV, other) and lives in or has traveled to a region endemic for Leishmania species.
(3) The patient from a country endemic for leishmaniasis has acalculous cholecystitis without evidence of cholesterolosis.
If a patient is suspected of having leishmaniasis then:
(1) examine histologic sections of the gallbladder carefully for evidence of leishmaniasis
(2) consider serologic testing
(3) consider molecular testing
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Specialty: Infectious Diseases