Infectious causes of appendicitis.

The pathologic spectrum of the inflamed appendix encompasses a wide range of infectious entities, some with specific histologic findings, and others with nonspecific findings that may require an extensive diagnostic evaluation. The appendix is exclusively involved in some of these disorders, and in others may be involved through extension from other areas of the gastrointestinal tract. This review discusses the pathologic features of bacterial, viral, fungal, and parasitic infections affecting the appendix, including adenovirus; cytomegalovirus; Yersinia, Actinomyces, Mycobacterium, or Histoplasma species; Enterobius vermicularis; schistosomiasis; and Strongyloides stercoralis. Pertinent ancillary diagnostic techniques and the clinical context and significance of the various infections are also discussed.

[1]  D. Connor,et al.  Enterobiasis: a histopathological study of 259 patients. , 1991, Annals of tropical medicine and parasitology.

[2]  H. Appelman,et al.  Another look at chronic appendicitis resembling Crohn's disease. , 1996, Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc.

[3]  T. Gleason,et al.  The pathology of Yersinia enterocolitica ileocolitis , 1982, The American journal of surgical pathology.

[4]  R. Makunike,et al.  Perforation of terminal ileum and appendix in typhoid enteritis: report of two cases. , 1997, East African medical journal.

[5]  M. Kenney,et al.  Infection of man with Trichuris vulpis, the whipworm of dogs. , 1978, The American journal of tropical medicine and hygiene.

[6]  D. Dieterich,et al.  Cytomegalovirus appendicitis in a patient with acquired immune deficiency syndrome. , 1991, The American journal of gastroenterology.

[7]  O. Rotimi,et al.  Schistosomiasis presenting as acute appendicitis. , 2007, East African medical journal.

[8]  V. Kapoor,et al.  Tuberculosis of the appendix--a report of 17 cases and a suggested aetiopathological classification. , 1987, Postgraduate medical journal.

[9]  M. Scott,et al.  Molecular detection of Campylobacter jejuni in archival cases of acute appendicitis , 2006, Modern Pathology.

[10]  T. Whalen,et al.  MEASLES AND APPENDICITIS , 1954, The American surgeon.

[11]  L. Lamps Appendicitis and infections of the appendix. , 2004, Seminars in diagnostic pathology.

[12]  Appelman Hd,et al.  Another look at chronic appendicitis resembling Crohn's disease. , 1996 .

[13]  U. Thisyakorn,et al.  Measles-associated appendicitis: two case reports and literature review. , 2001, Scandinavian journal of infectious diseases.

[14]  L. Lamps Beyond acute inflammation: a review of appendicitis and infections of the appendix , 2008 .

[15]  I. Bleiweiss,et al.  Cytomegalovirus-associated appendicitis in a patient with the acquired immunodeficiency syndrome. , 1990, The American journal of medicine.

[16]  E. Kuijper,et al.  Fatal mucormycosis presenting as an appendiceal mass with metastatic spread to the liver during chemotherapy-induced granulocytopenia. , 1990, Scandinavian journal of infectious diseases.

[17]  J. Lassen,et al.  Acute and Chronic Gastrointestinal Manifestations Associated With Yersinia enterocolitica Infection A Norwegian 10‐year Follow‐up Study on 458 Hospitalized Patients , 1992, Annals of surgery.

[18]  K. Horvath,et al.  Intestinal tuberculosis: return of an old disease , 1998, American Journal of Gastroenterology.

[19]  F. Chan,et al.  Isolation of Campylobacter jejuni from an appendix , 1983, Journal of clinical microbiology.

[20]  G. Vantrappen,et al.  Yersinia enteritis and enterocolitis: gastroenterological aspects. , 1977, Gastroenterology.

[21]  S. Chittal,et al.  Sarcoidosis with involvement of the appendix. , 1983, Archives of internal medicine.

[22]  D. Bugra,et al.  [Isolated tuberculosis of the appendix. Apropos of a case]. , 1990, Journal de chirurgie.

[23]  A. Weltzien,et al.  Actinomycosis of the appendix in childhood , 1999, Pediatric Surgery International.

[24]  M. Bronner Granulomatous appendicitis and the appendix in idiopathic inflammatory bowel disease. , 2004, Seminars in diagnostic pathology.

[25]  S. Yıldırım,et al.  A rare cause of acute appendicitis: Parasitic infection , 2005, Scandinavian journal of infectious diseases.

[26]  A. Weintraub,et al.  The role of Bacteroides fragilis in the pathogenesis of acute appendicitis. , 1982, Acta chirurgica Scandinavica.

[27]  E. Pahle,et al.  Enterobius vermicularis and acute appendicitis. , 1985, Acta chirurgica Scandinavica.

[28]  M. Satti,et al.  Appendicular schistosomiasis: a cause of clinical acute appendicitis? , 1987, Journal of clinical pathology.

[29]  C. Adebamowo,et al.  Schistosomiasis of the appendix , 1991, The British journal of surgery.

[30]  I. Komenaka,et al.  Strongyloides appendicitis: unusual etiology in two siblings with chronic abdominal pain. , 2003, Journal of pediatric surgery.

[31]  J. Naktin,et al.  Yersinia enterocolitica and Yersinia pseudotuberculosis. , 1999, Clinics in laboratory medicine.

[32]  L. Hirschowitz,et al.  Adenovirus and intranuclear inclusions in appendices in intussusception. , 1993, Journal of clinical pathology.

[33]  D. Connor Pathology of infectious diseases , 1997 .

[34]  M. Noble,et al.  Gastrointestinal features of culture-positive Yersinia enterocolitica infection. , 1987, Gastroenterology.

[35]  M. Cappell,et al.  Appendiceal infection byEntamoeba histolytica andStrongyloides stercoralis presenting like acute appendicitis , 1990, Digestive Diseases and Sciences.

[36]  R. Chetty,et al.  Cytomegalovirus infection in the gastrointestinal tract. , 1994, Journal of clinical pathology.

[37]  T. Madiba,et al.  Isolated amoebic appendicitis , 2002, Virchows Archiv.

[38]  R. Wenzel,et al.  Cytomegalovirus and appendiceal perforation in a patient with acquired immunodeficiency syndrome. , 1989, Southern medical journal.

[39]  J. Coyne,et al.  Involvement of the appendix in pseudomembranous colitis. , 1997, Journal of clinical pathology.

[40]  C. Couto,et al.  Actinomycosis of the colon: a rare form of presentation. , 2000, Scandinavian journal of gastroenterology.

[41]  E. Montgomery,et al.  Intussusception, adenovirus, and children: a brief reaffirmation. , 1994, Human pathology.

[42]  Aleem Hm,et al.  Unusual presentations of abdominal tuberculosis. , 1994, Canadian journal of surgery. Journal canadien de chirurgie.

[43]  H. Mollaret,et al.  Antibiotic treatment of Yersinia enterocolitica septicemia: a retrospective review of 43 cases. , 1993, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[44]  O. Wangensteen,et al.  SIGNIFICANCE OF THE OBSTRUCTIVE FACTOR IN THE GENESIS OF ACUTE APPENDICITIS: AN EXPERIMENTAL STUDY , 1937 .

[45]  R. Bennion,et al.  The role of Yersinia enterocolitica in appendicitis in the southwestern United States. , 1991, The American surgeon.

[46]  B. Wiebe Appendicitis and Enterobius vermicularis. , 1991, Scandinavian journal of gastroenterology.

[47]  P. Domingo,et al.  Appendicitis due to Mycobacterium avium complex in a patient with AIDS. , 1996, Archives of Internal Medicine.

[48]  Chapman Cb Letter: Accelerated students. , 1975 .

[49]  J. Greenson,et al.  Histopathology of Interval (Delayed) Appendectomy Specimens: Strong Association With Granulomatous and Xanthogranulomatous Appendicitis , 2003, The American journal of surgical pathology.

[50]  R. Reif Viral appendicitis. , 1981, Human pathology.

[51]  L. Neumayer,et al.  Cytomegalovirus appendicitis in a patient with human immunodeficiency virus infection. Case report and review of the literature. , 1993, Archives of surgery.

[52]  G. Cook The clinical significance of gastrointestinal helminths--a review. , 1986, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[53]  M. Scavizzi,et al.  Failure of beta-lactam antibiotics and marked efficacy of fluoroquinolones in treatment of murine Yersinia pseudotuberculosis infection , 1991, Antimicrobial Agents and Chemotherapy.

[54]  Noodleman Js Eosinophilic appendicitis. Demonstration of Strongyloides stercoralis as a causative agent. , 1981 .

[55]  T. N. Saari,et al.  Clinical and laboratory aspects of Yersinia pseudotuberculosis infections, with a report of two cases. , 1976, American journal of clinical pathology.

[56]  M. Bronner,et al.  Pathogenic Yersinia DNA Is Detected in Bowel and Mesenteric Lymph Nodes From Patients With Crohn's Disease , 2003, The American journal of surgical pathology.

[57]  J. Roberts,et al.  Quantitative bacterial flora of acute appendicitis. , 1988, Archives of disease in childhood.

[58]  I. Alafuzoff,et al.  Granulomatous peritonitis and appendicitis of food starch origin. , 1991, Gut.

[59]  P. Dean,et al.  Idiopathic granulomatous appendicitis, or Crohn's disease of the appendix revisited. , 1993, Human pathology.

[60]  Rajiv,et al.  Bacteriology of acute appendicitis with special reference to anaerobes. , 1994, Indian journal of pathology & microbiology.

[61]  P. Brouqui,et al.  Schistosomiasis as an unusual cause of appendicitis. , 2004, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[62]  R. Pierce,et al.  The Role of Yersinia enterocolitica and Yersinia pseudotuberculosis in Granulomatous Appendicitis: A Histologic and Molecular Study , 2001, The American journal of surgical pathology.

[63]  R. Schapers,et al.  Mesenteric lymphadenitis due toYersinia enterocolitica , 2005, Virchows Archiv A.

[64]  E. Yunis,et al.  Adenovirus and ileocecal intussusception. , 1975, Laboratory investigation; a journal of technical methods and pathology.

[65]  G. Wauters,et al.  Causative role ofYersinia and other enteric pathogens in the appendicular syndrome , 1991, European Journal of Clinical Microbiology and Infectious Diseases.

[66]  Y. Okada,et al.  Acute appendicitis caused by amebiasis , 2000, Journal of Gastroenterology.

[67]  W. Bradford,et al.  Pathologic features of enteric infection with Yersinia enterocolitica. , 1974, Archives of pathology.

[68]  N. S. Mair,et al.  The histopathology of enteric infection with Yersinia pseudotuberculosis. , 1979, American journal of clinical pathology.

[69]  A. Agarwal,et al.  Tuberculous Appendicitis in India , 2004, Tropical doctor.

[70]  F. Pardo‐Mindán,et al.  Cytomegalovirus infection of the appendix in patient with the acquired immunodeficiency syndrome. , 1991, Gastroenterology.

[71]  Yunis Ej,et al.  Adenovirus and ileocecal intussusception. , 1975 .

[72]  A. West,et al.  The pathologic spectrum of gastrointestinal and hepatic histoplasmosis. , 2000, American journal of clinical pathology.

[73]  M. Harlow,et al.  Superficial mucosal ulceration and the pathogenesis of acute appendicitis. , 1971, American journal of surgery.

[74]  D. Day,et al.  Inflammatory Disorders of the Appendix , 2008 .

[75]  E. Arnbjörnsson,et al.  Role of obstruction in the pathogenesis of acute appendicitis. , 1984, American journal of surgery.

[76]  J. Lindeman,et al.  Campylobacter-associated appendicitis: prevalence and clinicopathologic features. , 1987, Pathology annual.

[77]  W. A. Eyer-Silva,et al.  Mycobacterial spindle cell pseudotumor of the appendix vermiformis in a patient with aids. , 2001, The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases.

[78]  J. Myers,et al.  Acute appendicitis in the setting of Clostridium difficile colitis: case report and review of the literature. , 2007, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[79]  A. López-Navidad,et al.  Acute appendicitis complicating infectious mononucleosis: case report and review. , 1990, Reviews of infectious diseases.

[80]  W. Yang,et al.  Measles-related appendicitis. , 2009, Archives of pathology & laboratory medicine.

[81]  E. Arnbjörnsson Acute appendicitis and dietary fiber. , 1983, Archives of surgery.

[82]  M. Stokes,et al.  Emergency laparotomy in patients with AIDS , 1992, The British journal of surgery.

[83]  S. Bell,et al.  Biotype and antibiotic sensitivity of 100 clinical isolates of Yersinia enterocolitica. , 1991, The Journal of antimicrobial chemotherapy.

[84]  M. Al-Adnani,et al.  Bacteroides fragilis is a silent pathogen in acute appendicitis. , 1986, Journal of medical microbiology.

[85]  N. Carr The pathology of acute appendicitis. , 2000, Annals of diagnostic pathology.

[86]  S. Sinha,et al.  Appendicular perforation due to Ascaris lumbricoides. , 1974, Journal of the Indian Medical Association.

[87]  J. Groner,et al.  Clinical manifestations of appendiceal pinworms in children: an institutional experience and a review of the literature , 2004, Pediatric Surgery International.