Abstract
Xanthogranulomatous cholecystitis (XGC) is a rare form of chronic gallbladder inflammation that most commonly presents as acute cholecystitis and is often mistaken for carcinoma of the gallbladder. This case details the hospital course and follow-up of a 77-year-old male who developed suspected acute acalculous cholecystitis (AAC) resulting in severe sepsis after elective left total knee arthroplasty (TKA). Histopathological findings after elective cholecystectomy later revealed XGC as the underlying etiology.