Appendiceal Perforation and Shigellosis

Ja, Tovar; Ep, Trallero; Garay, J

doi:10.1055/s-2008-1060023

Cited by 4 publications

(3 citation statements)

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“…In literature, there are few reports of gangrenous appendicitis and localized peritonitis, associated with Shigella spp. gastroenteritis in pediatric and adult patients [2,3,[15][16][17][18][19]. Interestingly, our patient did not have diarrhea.…”

Section: Discussionmentioning

confidence: 88%

Shigillosis with Acute Appendicitis and Peritonitis: A Case Report

Bahri¹,

Saffour²,

Elfarssani³

et al. 2020

FEM

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Shigellosis is a form of bacterial diarrhea caused by gram-negative bacteria Shigella species. It is common in developing countries and results from contaminated food, poor sanitation conditions, or direct person to person contact. Shigella can cause infection in all age groups. High-risk group include very young, elderly, and immunocompromised person. Shigella species is relatively resistant to acid in the stomach, and few organisms are required to cause the disease. Once ingested, it multiplies in the small intestine and enters the colon. In the colon, it produces shigella enterotoxins and serotype toxin 1, resulting in watery or bloody diarrhea. Clinical presentation of shigellosis may vary over a wide spectrum from mild diarrhea to severe dysentery. We report the case of 7 years old previously healthy boy, who presented to our hospital with abdominal pain, vomiting, and constipation. On examination, we noticed abdominal tenderness with guarding at the right lower quadrant. With the diagnosis of acute appendicitis, open appendectomy was performed. Exploration of the abdominal cavity revealed perforated appendicitis and generalized peritonitis. Shigella sonnei was isolated from the peritoneal fluid culture. The patient completely recovered without any complications. Surgical complications, including appendicitis, could have developed during shigellosis. There are few reported cases of perforated appendicitis associated with Shigella. Prompt surgical intervention can be beneficial to prevent morbidity and mortality if it is performed early in the course of the disease.

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Section: Discussionmentioning

confidence: 88%

Shigillosis with Acute Appendicitis and Peritonitis: A Case Report

Bahri¹,

Saffour²,

Elfarssani³

et al. 2020

FEM

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show abstract

“…In literature, there are few reports of gangrenous appendicitis and localized peritonitis, associated with Shigella spp. gastroenteritis in pediatric and adult patients (2,3,(12)(13)(14)(15)(16). Interestingly, our patient did not have diarrhea.…”

Section: Discussionmentioning

confidence: 99%

Unusual Presentation of Shigellosis: Acute Perforated Appendicitis and Peritonitis

Bayhan¹,

Tanır²,

Maden³

et al. 2015

J Pediatr Inf

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Shigella spp. gelişmekte olan ülkelerde bakteriyel ishal ve dizanterinin en sık etkenidir. Şigellozisin klinik bulguları hafif ishalden ciddi dizanteriye kadar değişen geniş bir klinik yelpaze göstermektedir. Beş buçuk yaşında daha önce sağlıklı olan erkek hasta karın ağrısı, kusma ve kabızlık ile başvurmuştu. Fizik muayenede sağ alt kadranda hassasiyet saptandı. Hastaya akut apendisit tanısı ile açık apendektomi işlemi yapıldı. Abdominal kavitenin cerrahi olarak açılması ile perfore apendisit ve yaygın peritonit tespit edildi. Peritoneal sıvı kültüründe Shigella sonnei üredi. Hasta komplikasyon gelişmeksizin tam olarak iyileşti. Şigellozisin seyri sırasında apendisitte dahil olmak üzere cerrahi komplikasyonlar gelişebilmektedir. Literatürde Shigella ilişkili perfore apendisit olgusu oldukça az sayıda bildirilmiştir. Erken cerrahi girişim morbidite ve mortaliteyi önlemde yararlıdır.

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“…Over the last 20 years only four case reports of Shigella-associated appendicular syndrome have been published (29)(30)(31)(32). Thus Yersinia enterocolitica is the most frequent but not the only enteric pathogen isolated from patients with suspected acute appendicitis.…”

Section: Discussionmentioning

confidence: 99%

Causative role ofYersinia and other enteric pathogens in the appendicular syndrome

Noyen

Selderslaghs

Bekaert

et al. 1991

Eur. J. Clin. Microbiol. Infect. Dis.

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In 2,861 consecutive patients undergoing appendicectomy for clinically suspected appendicitis an enteric pathogen was isolated from the appendix in almost 7% using an optimal combination of culture media. The pathogenic Yersinia enterocolitica serotypes 03 and 09 predominated (3.6%), followed by Campylobacter and nontyphoid Salmonella. The same pathogen was isolated from the stool in 72.5% of patients with a culture-positive appendix and in 84.1% of those positive for a pathogenic Yersinia. Conversely, no pathogenic Yersinia were isolated in 326 gynaecologic control patients, in whom a normal appendix was removed. No frank appendicitis but mesenteric adenitis and/or terminal ileitis were found in 62.3% of 138 patients with a culture positive appendix, and in 74.6% of those positive for a pathogenic Yersinia. Histologic findings available in 135 patients showed acute suppurative appendicitis in only six (4.5%) patients, and in only one of 73 (1.4%) positive for a pathogenic Yersinia. In contrast, 46.8% of a group of 345 culture-negative appendices showed acute inflammation. A positive stool culture in a patient with suspected appendicitis, if consistent with sonographic and clinical findings, should be taken as strong evidence against the presence of true appendicitis.

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Appendiceal Perforation and Shigellosis

Abstract: Appendiceal perforation and shigella enteritis were concomitantly observed in a 5-year-old boy. S. Sonnei was recovered from peritoneal exudate and faeces. This association must be kept in mind when treating patients with abdominal pain and gastroenteritis.

Cited by 4 publications

References 0 publications

Shigillosis with Acute Appendicitis and Peritonitis: A Case Report

Shigillosis with Acute Appendicitis and Peritonitis: A Case Report

Unusual Presentation of Shigellosis: Acute Perforated Appendicitis and Peritonitis

Causative role ofYersinia and other enteric pathogens in the appendicular syndrome

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