Although Bipolaris fungus is ubiquitous in the environment, its involvement in infectious complications of ERCP has never been reported. We present the case of a 29 year old black male who presented with recurrent right upper quadrant abdominal pain and jaundice for three months. CT scan of the abdomen revealed a prominent pancreatic head with diffuse dilation of intra- and extrahepatic ducts as well as the pancreatic duct. The patient then underwent ERCP, which was subsequently followed by acute cholecystitis. Operative findings revealed inflammation in the porta hepatis as well as the pancreatic head and a necrotic gallbladder. Histopathology of lymph nodes showed granulomatous eosinophilic lymphadenitis, whereas the gallbladder had transmural acute eosinophilic and granulomatous cholecystitis with hyphae. Cultures grew out Bipolaris species. The tissue reaction was similar to that commonly seen in the lungs with allergic bronchopulmonary aspergillosis.
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