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CASE REPORT
Year : 2019  |  Volume : 11  |  Issue : 1  |  Page : 47-49

Recurrence of Citrobacter koseri-associated intra-abdominal infection 2 years after spilled gallstones during laparoscopic cholecystectomy


1 Department of Internal Medicine, Stony Brook University Hospital, New York, USA
2 Department of Pathology, Veteran's Affairs Medical Center, New York, USA
3 Department of Infectious Diseases, Stony Brook University, School of Medicine, Stony Brook; Veterans Affairs Medical Center, Northport, New York, USA

Correspondence Address:
Dr. George Psevdos
79, Middleville Road, Northport, New York 11768
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2153-3539.251845

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Spilled gallstones during laparoscopic cholecystectomy (LC) are common. Lost gallstones can lead to complications such as intra-abdominal abscesses, which can occur days, months, or even years after the procedure. Citrobacter koseri belongs to the family of Enterobacteriaceae. It is a low-virulence pathogen; however, it is linked to infections of the urinary tract and abdomen. We report the case of a 70-year-old diabetic male who presented with C. koseri- associated subhepatic abscess. Two years prior, he had emphysematous cholecystitis and liver abscess caused by C. koseri. During his LC, gallstones were spilled in the abdominal cavity and every effort was made to retrieve them. However, 2 years later, an aspiration of the subhepatic abscess revealed cholesterol fragments. We hypothesize that dislodged cholesterol gallstones and bile, contaminated with C. koseri, were the culprits for the appearance of the subhepatic abscess with the same organism 2 years after the LC.


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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008