Japanese Spotted Fever Complicated with Cholecystitis: A Case Report.

INTRODUCTION

Japanese spotted fever (JSF) is a tick-borne infection caused by Rickettsia japonica, classically presenting with the triad of fever, rash, and eschar, and characterized by systemic vasculitis resulting from endothelial injury. Concomitant cholecystitis associated with JSF is exceedingly rare.

CASE PRESENTATION: We report the case of a 77-year-old man who presented with fever, was diagnosed with calculous cholecystitis at a referring hospital, and underwent laparoscopic cholecystectomy. Postoperatively, erythema developed on the extremities and trunk, along with an eschar on the right ankle. Polymerase chain reaction (PCR) testing subsequently detected R. japonica, confirming JSF. The ischemic injury secondary to vasculitis may have contributed to the development of cholecystitis.

CONCLUSIONS

Even in calculous cholecystitis, JSF should be considered in endemic areas when rash or eschar is present, highlighting the importance of early PCR testing and the prompt administration of tetracyclines.