Bowel Infection and Acute Appendicitis

White, Matthew; Lord, Martin; Rogers, Kandace

doi:10.1136/adc.36.188.394

Cited by 11 publications

(8 citation statements)

References 18 publications

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“…Repair is not as advanced in the appendix as it is in the colon of the same patient, and given the correct circumstances, appendicitis requiring operative treatment may evolve. [37][38][39] The four patients reported by Story and Han-bury4" had different alimentary tract histology. It is possible that polyarteritis nodosa contributed more to the pathology of their case 1 than the authors believed.…”

Section: Discussionmentioning

confidence: 97%

Pathology of the alimentary tract in Salmonella typhimurium food poisoning.

Boyd¹

1985

Gut

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SUMMARY The pathology of the alimentary tracts of nine patients dying of Salmonella typhimurium infection is reviewed. Two patients had previous gastric operations, supporting previous reports that such patients are more susceptible to food poisoning. Four had no parietal (oxyntic) cells in the gastric mucosa, suggesting hypo-or anacidity. Only one had acute gastritis. None had acute enteritis, but in half of the patients, subtle histological changes suggested an 'enteropathy'. Acute diffuse colitis with abundant crypt abscesses, without stromal abscesses in the lamina propria, was the most constant finding and reparative features started very early, and occurred in later deaths. Under ideal circumstances this crypt abscess is readily distinguished from that of idiopathic ulcerative colitis, but can be confused with the crypt abscess of acute bacillary (sonne) dysentery. While the florid colonic changes may have settled in the late deaths, active inflammation is commonly present in the appendix mucosa on histology. The pathology of the alimentary tract in S typhimurium infection differs from that of S typhi and S paratyphi infections. There is little evidence of gastroenteritis, although subtle changes occur in the stomach and small intestine. The features are those of acute diffuse colitis with histological appendicitis, distinguishable from idiopathic ulcerative colitis.Statistics suggest that the incidence of food 1,oisoning in the United Kingdom is increasing. Food poisoning is commonly referred to as 'gastroenteritis', implying inflammation of the stomach and small intestine. During an outbreak of S typhimurium (phage type 32) infection in the west of Scotland in 1968, it was surprising to find virtually no gastritis, or enteritis, and that the predominant histological lesion was an acute diffuse colitis.2Further experience has been gained from S typhimurium infection of other phage types and from other salmonella subtypes.3 Other publications-11 have confirmed the colitis component of S typhimurium infection, but the findings in the stomach and small intestine remain un-reported. Indeed, the colonic findings have not been adequately described. In this paper the pathology of the alimentary tract in nine patients dying from S typhimurium infection, involving at least four phage types is described. The first necropsy was done before phage typing had been routinely accepted. Methods NECROPSIESThe nine necropsies were carried out as soon after death as possible. Two loops of jejunum and two of sigmoid colon were sent for microbiological examination and virology. Blood samples from the right auricle were also taken for culture and Widal tests.The necropsy was standard with the gastrointestinal tract being dissected out and opened with the minimum of handling. Hosing with water and sponging was avoided to allow inspection of the luminal contents and the undisturbed mucosal surfaces.After formalin fixation standard sets of blocks for histological examination were taken from the gastric fundus, jejunum, jejuno-ile...

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Section: Discussionmentioning

confidence: 97%

Pathology of the alimentary tract in Salmonella typhimurium food poisoning.

Boyd¹

1985

Gut

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“…In general, transmission route of gastrointestinal tract infectious diseases is often fecal-oral. This is also likely true for clustered appendicitis as microbes in gastrointestinal tract and in oral cavity were found in the inflamed appendices (14)(15)(16)(17)(18)(19)(20)(27)(28)(29)(30)(31)(32). In addition, the cluster of appendicitis in the United States was associated with food intake.…”

Section: Discussionmentioning

confidence: 94%

Cluster of Acute Appendicitis Among High School Tibetan Students in Nanchang, China: Investigation, Control, and Prevention

Guo

Yang

et al. 2022

Front. Public Health

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ObjectiveInfectious etiology of acute appendicitis is a current hot topic. The most of study on appendicitis came from sporadic patients and focused on clinical treatment rather than control and prevention of appendicitis in the population. The present study aims to investigate the epidemiological features of cluster of acute appendicitis, risk factors, and evaluate effectiveness of control and prevention in population.MethodsWe conducted longitudinal study on a cluster of acute appendicitis among Tibetan students at a high school in eastern China, which was divided into three stages: 1. We retrospectively collected epidemiological data and clinical data to explore risk factor and possible transmission route in August of 2005; 2. We conducted targeted measures from August of 2005 and analyzed incidence trend from 2000 to 2010; 3. Since no new patients occurred in 2011, we conducted surveillance from the beginning of 2012 until July 2018.ResultsAmong 973 Tibetan students, there were 120 patients with more female patients (102 of 499, 20.4%) than male patients (18 of 474, 3.8%) from January of 2000 to December of 2010. The 4-year cumulative incidence rates in female students enrolled in 2001, 2002, 2003, 2004, 2005, 2006 were 26.8% (11 of 41), 27.1% (13 of 48), 44.7% (21 of 47), 42.4% (14 of 33), 23.1% (9 of 39), and 19.3% (11 of 57), respectively before their graduation. There was a clustering feature. Mutual contact with patients before the onset of symptoms was an important risk factor (Adjusted OR 4.89, 95% CI: 1.67–14.35). Transmission route may be fecal-oral infection. Before conducting targeted measures, the incidence rate increased from 2000 and peaked in 2005. After conducting targeted measures, the incidence rate decreased year by year until 2010. Under surveillance from January of 2012 to July of 2018, only four sporadic patients occurred at this school.ConclusionThis cluster of acute appendicitis had features of an infectious disease in epidemiology, which can be controlled and prevented by targeted measures. Our study may also be used for prevention of sporadic patients and be generalized in general population as cluster of appendicitis occurred in many provinces of China.

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“…In 1961, White et al [13] examined appendectomy materials of 160 pediatric cases of acute appendicitis: S. sonnei was detected 12 (7.5%) of them who had diarrhea before or after operation. In 1974, Leigh et al [14] examined 153 appendices of adult and pediatric patients, Shigella spp.…”

Section: Discussionmentioning

confidence: 99%

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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Bowel Infection and Acute Appendicitis

Cited by 11 publications

References 18 publications

Pathology of the alimentary tract in Salmonella typhimurium food poisoning.

Pathology of the alimentary tract in Salmonella typhimurium food poisoning.

Cluster of Acute Appendicitis Among High School Tibetan Students in Nanchang, China: Investigation, Control, and Prevention

Shigillosis with Acute Appendicitis and Peritonitis: A Case Report

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