a 35-year - old healthy lady presented with high grade fever , severe abdominal pain , nausea , vomiting and profuse watery diarrhea , sometimes green in color .
there was no history of animal contact , recent travel or camping . on exam , the patient was hypotensive and was looking acutely ill .
she also had hypokalemia of 3.3 mmol / l , acute kidney injury with elevated creatinine of 1.6 mg / dl from a baseline of 0.6 secondary to dehydration .
murphy 's sign was positive which prompted us to do a right upper quadrant ultrasound which showed thickened gall bladder wall of upto 1 cm consistent with cholecystitis .
patient started feeling better after the surgery and was discharged home . during the post - hospitalization follow - up after 2 weeks
campylobacter is a small , slender , gram - negative curved rod , which is one of the most common causes of enteritis in humans .
campylobacter fetus may have some attraction towards the gallbladder as in a survey , 20% of slaughtered 700 cattle and sheep harbored this bug in their gallbladder.1 campylobacter can cause cholecystitis without diarrhea unlike the case that we report here .
the diagnosis of campylobacter cholecystitis is usually missed because culture of campylobacter is not routinely requested after cholecystectomy . however , even if the bile is cultured , campylobacter appears to be a less common cause of cholecystitis .
darling et al cultured about 280 bile samples post cholecystectomy for campylobacter . but none of them grew campylobacter.2 hence routine ordering of bile culture under microaerophilic condition is not recommended unless the gram stain shows gram negative curved rods .
3 resistance of campylobacter fetus to cephalosporins and penicillins was reported as early as 1986.4 majority of the reported cases including our patient had good outcome with cholecystectomy and antibiotics especially erythromycin ( see table 1 ) .
only one of the reported cases died , however she had advanced hepatocellular carcinoma.3 there is one case report of relapse of campylobacter bacteremia in a aids patient in about 8 months after the first episode of campylobacter cholecystitis.1 in conclusion , campylobacter cholecystitis is rare but should be kept in the back of the mind while treating a patient with campylobacter enteritis .
 there are 13 cases of campylobacter cholecystitis reported so far in the medical literature . among them , only 4 patients had diarrhea . 
 we report another case of acalculous cholecystitis in a setting of campylobacter enteritis . 
 the case report is followed by a literature review regarding this rare condition . 
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Discussion