Typhoid infection of the gallbladder

Typhoid infection of the gallbladder

Salmonella Typhi or Salmonella Typhimurium can infect the gallbladder. Acute or, more frequently , chronic cholecystitis occurs, with the patient becoming a typhoid carrier excreting the bacteria in the bile. Gallstones may be present (surgeons should not give patients their stones after their operation if there is any suspicion of typhoid). It is debatable whether the stones are secondary to the Salmonella cholecystitis or whether pre-existing stones predispose the gallbladder to chronic infection. Treatment with ampicillin and cholecystectomy are indicated. In the case of penicillin allergy , a quinolone antibiotic can be used.

Figure 71.27 The interior of a strawberry gallbladder (cholesterosis) (courtesy of Dr Sanjay P Thakur, Patna, India). Figure 71.28 Types of cholecystitis glandularis proliferans (polyps, intra

mural or diverticular stones and /f_i stula).