Journal of Ultrasound in Medicine, Vol 17, Issue 4 231-237, Copyright © 1998 by American Institute of Ultrasound in Medicine
Sonographic analysis of gallbladder findings in Salmonella enteric fever
P. B. Shetty and D. R. Broome
Department of Radiology, St. John's Medical College Hospital, Bangalore, India.
The purpose of this study was to analyze gallbladder sonographic findings
associated with Salmonella typhi enteric fever. Sixty-two patients with
culture positive Salmonella enteric fever were analyzed with serial
sonography. The following gallbladder sonographic findings were noted:
globular gallbladder distention (33 of 62 patients, 530%), positive
sonographic Murphy sign (25 patients, 40%), pericholecystic edema or fluid
(25 patients, 40%), gallbladder wall thickening > 4 mm (21 patients,
34%), low-level nonshadowing intraluminal echoes or sludge (nine patients,
15%), intramural linear sonolucency or striation (eight patients, 13%), and
mucosal irregularity or sloughed membrane (four patients, 6%). Using the
sonographic findings a gallbladder score was devised to assess the severity
of gallbladder changes, and the score was correlated with the following
clinical parameters--duration of fever, multidrug resistance, and clinical
outcome. An abnormal gallbladder score was noted in 37 patients (60%), and
multidrug resistance was noted in 35 of these patients (95%). The
gallbladder scores showed a strong positive correlation with the duration
of fever and the frequency of multidrug resistance. All 62 patients were
treated with intensive antibiotic therapy without any deaths.
