A “Shocking” Appendicitis

Abstract

We report a case of Klebsiella oxytoca sepsis as a complication of nonperforated appendicitis in an 11-year-old immunocompetent boy. Even if septicemia is not mentioned in major reviews as a complication of nonperforated appendicitis, several cases have occasionally been reported in adult patients in the literature. The pathogenesis of sepsis with nonperforated appendicitis is still not clear, but a mechanism of bacterial translocation has been taken into account to explain the spread of microorganisms from the intestinal lumen to the systemic blood stream. Clinicians should therefore be aware of this occurrence.

Sepsis after non‐perforated acute appendicitis

“…However, the pathogenesis of sepsis in a non‐perforated appendix is still unknown . But it has been suggested it may occur due to the release of microorganisms from the lumen of the intestine into systemic blood flow . The greatest delay in the diagnosis of acute appendicitis occurs in children who are referred to the clinic with symptoms of acute gastroenteritis.…”

“…24 But it has been suggested it may occur due to the release of microorganisms from the lumen of the intestine into systemic blood flow. 23 The greatest delay in the diagnosis of acute appendicitis occurs in children who are referred to the clinic with symptoms of acute gastroenteritis. Common causes of delayed or misdiagnosis in under 5 children is chiefly due to non-specific clinical manifestation, inability to communicate nature and precise location of pain, inadequate examination consequently leading to perforation and other complications.…”

“…The patient had all sepsis symptoms, and appendectomy had shown inflamed non‐perforated appendicitis. According to Gortani et al, Sepsis Klebsiella has been reported as a non‐perforated acute appendicitis in a 11‐year‐old child with normal immune system. However, the pathogenesis of sepsis in a non‐perforated appendix is still unknown .…”

Bacterial Translocation from Intestine: Microbiological, Immunological and Pathophysiological Aspects

“…В то же время имеются клинические доказательства взаимосвязи БТ и сепсиса. Так, связь БТ с развитием септических проявлений, вызванных микро-организмами Klebsiella oxytoca, наблюдалась как осложне-ние неоперабельного аппендицита даже у иммунокомпе-тентных детей [51].…”