Cholecystitis

Calculous cholecystitis (>90%) refers to inflammation of the gallbladder as a complication of gallstone disease, causing RUQ pain, fever, leukocytosis and often, secondary infection

Acalculous cholecystitis (5-10%) results from gallbladder stasis and ischemia in the absence of gallstones, and is typically seen in hospitalized patients

Surgical/gastroenterology consult for definitive management (e.g. cholecystectomy)

Significant bilirubin and ALP elevations not common in uncomplicated disease

Biliary cultures are negative in most patients with gallstones, but are useful for those with complicated or acalculous cholecystitis

Blood cultures in severely ill and health care associated cholecystitis

Procalcitonin (PCT) not usually useful

Empiric Therapy