This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Gallbladder, Subject name: Surgery
Best treatment for the given type of cholecystitis is: 
Select and explain. 
A. Urgent cholecystectomy or cholecystostomy under antibiotic coverage, B. Conservative management followed by interval cholecystectomy, C. Conservative treatment and treat primary cause like DM, D. Urgent ERCP
A: Urgent cholecystectomy or cholecystostomy under antibiotic coverage
Answer: A: Urgent cholecystectomy or cholecystostomy under antibiotic coverage 
Explanation: In X-Ray, GB shows presence of air, that gives the diagnosis of emphysematous cholecystitis. M.C organism responsible for emphysematous cholecystitis is clostridium perfringens (anaerobe). M.C aerobic organism responsible is E. coli. - Cause of Xanthogranulomatous cholecystitis ( non -infectious condition)- rupture of Rokitansky-Aschoff sinuses. Investigation of choice: NCCT. Rx: Urgent cholecystectomy or cholecystostomy + antibiotics.