Primary Epstein-Barr virus-associated acute acalculous cholecystitis and Gianotti-Crosti syndrome

Wendy Jie-Ying Wu^a, Daniel Tsung-Ning Huang^b

^a Department of Family Medicine, Buddhist Tzu Chi General Hospital, Taipei Branch, New Taipei City, Taiwan
^b Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan

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Abstract
A 15-year-old boy presented with fever, upper respiratory tract symptoms, cervical lymphadenopathy, and vague abdominal symptoms. Abdominal ultrasound findings were consistent with acute acalculous cholecystitis. Serology was positive for acute Epstein-Barr virus (EBV) infection. The patient recovered and was discharged, but returned 1 week later with an acute, symmetric, papulovesicular exanthem on his forearms and lower legs, which was consistent with Gianotti-Crosti syndrome. Although the latter is not uncommonly associated with EBV infection, acalculous cholecystitis of viral origin is exceedingly rare in children.

Keywords
Acalculous cholecystitis; Epstein-Barr virus; Gianotti-Crosti syndrome