Background: Lai et al. reported 18 cases of Cystoisospora belli in the gallbladders (GBs), detected incidentally in 0.5% ofimmunocompetent patients (PMID: 27158759). However, a recent molecular study failed to confirm this observation at molecular level(PMID: 30020094). Although Lai et al. indicated that Cystoisospora in the GB is quiescent in immunocompetent patients, this diagnosisnevertheless has major implications, resulting in extensive patient workup for undetected immunosuppression.United States & Canadian Academy of Patholog