Gallbladder adenomyomatosis presenting as fever of unknown origin: A case report

Gallbladder adenomyomatosis is a rare disorder, characterized by benign hyp erplasia of the gallbladder mucosa creating invaginations through the muscu lar layer, known as Rokitansky-Aschoff sinuses. It is considered an acquire d disease, with pathophysiology similar to that of the diverticular disease of the colon. Diagnosis is often achieved by ultrasound, but a significant percentage is misdiagnosed as chronic cholecystitis, whereas the diagnosis is finally achieved histologically. We describe a case of gallbladder aden omyomatosis presenting as fever of unknown origin. The patient was a 17-yea r-old girl with a history of sustained fever of 38.5 degreesC of two months ' duration. There were no accompanying symptoms and the whole diagnostic wo rkup, including abdominal ultrasound, was negative. Gallbladder inflammatio n was evident: during an eventual investigatory laparoscopy, and cholecyste ctomy was performed. The histologic results were consistent with diffuse ad enomyomatosis. The patient became afebrile immediately after cholecystectom y. To our knowledge, fever has never been associated with gallbladder adenomyo matosis before in bibliography, nor has adenomyomatosis been mentioned as a cause of fever of unknown origin. We therefore believe that gallbladder ad enomyomatosis should be considered in the differential diagnosis of sustain ed fever with negative workup.