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Query: UMLS:C0085693 (acute appendicitis)
 3,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The gross and microscopic pathologic changes in 70 cases of serologically proven enteric infections with Yersinia pseudotuberculosis are presented. The highest incidence was in young males, and the commonest infecting organism belonged to serologic O-group I. Clinically, the illness resembled acute appendicitis, but the most consistent finding at laparotomy was mesentric lymphadenitis. Surgical specimens examined included 69 mesenteric lymph nodes, 18 appendices, five terminal ileums, and two ascending colons. Histologically, four stages of the disease were identified, leading to the formation of characteristic granulomas with central necrosis and microabscess formation. Ulceration of the intestinal and appendicular mucosa may occur. The illness usually runs a benign course, and antibiotic treatment is rarely necessary. The pathogenesis and differential diagnosis are discussed with reference to the current literature.
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PMID:The histopathology of enteric infection with Yersinia pseudotuberculosis. 37 42

Clinical picture and differential diagnosis of Yersinia arthritis are shown by means of three own observations. It is an acute oligoarthritis affecting especially knee- and ankle-joints. The involved joints are very painful, swollen and warm. There may be a history of enteritis or suspicion of acute appendicitis because of lower abdominal pain, but this is not obligatory. The laboratory parameters of inflammation (ESR, C-reactive protein, white blood count, serumproteinelectrophoresis) are changed significantly. Diagnosis is made by serum agglutination reaction (Widal-reaction) against ceesurface antigens (O-antigens) of Yersinia enterocolitica. Almost only people with the HL-A antigen B27 tend to get arthritis during Yersinia infection. The differential diagnosis has to consider reactive arthritis during Salmonella or Shigella infections, acute sarcoidosis, Reiter's disease and rheumatoid arthritis.
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PMID:[Yersinia arthritis (author's transl)]. 52 13

Yersinia pseudotuberculosis infections in two bacteriologically confirmed cases are described. A child was found to have mesenteric adenitis and an adult had septicemia. Invariably simulating acute appendicitis, mesenteric adenitis most often occurs in male children and adolescents. Septicemia with this organism usually affects elderly, debilitated patients, who frequently have chronic hepatic disease. The infrequent diagnosis of infection with Yersinia pseudotuberculosis in the United States is probably due to failure to consider it a human pathogen. Currently classified with the Enterobacteriaceae, Yersinia pseudotuberculosis in a non-lactose-fermenting, Gram-negative coccobacillus. It is sensitive to a wide range of antibiotics, including tetracycline and streptomycin, but usually is resistant to ampicillin. Yersinia pseudotuberculosis has a worldwide distribution in wild and domestic mammals and birds. Infections in man may result from direct contact with infected animals or their excreta.
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PMID:Clinical and laboratory aspects of Yersinia pseudotuberculosis infections, with a report of two cases. 77 44

In 895 patients operated on for acute appendicitis we found Yersinia enterocolitica in 41 cases. Another two cases were detected in postoperative serological examinations. Lymphadenitis mesenterialis was present in 17 cases during operation. Once we detected a regional enteritis. Histological examination of the appendix revealed a purulent inflammation in 21 cases and a phlegmonous-gangrenous inflammation in 4 cases. The other 18 patients suffered from Oxyuriasis, coprostasis or scars of the appendix. For this reason it is impossible to exclude an acute appendicitis in patients with cultural or serological identification of Yersinia enterocolitica.
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PMID:[Yersinia enterocolitica in acute appendicitis, lymphadenitis mesenterialis and regional enteritis (author's transl)]. 96 Nov 57

Infection with Yersinia enterocolitica had been associated with acute appendicitis in approximately six per cent of patients in northern European countries. However, the incidence of Y. enterocolitica in patients with appendicitis in this country is uncertain. Therefore, this study was undertaken to ascertain whether Y. enterocolitica is a possible infectious agent in appendicitis in the southwestern United States. Fifty prospective patients (35 men and 15 women) with an average age of 22.3 years (range 3 to 62 years) underwent appendectomy for presumed appendicitis. Portions of each specimen were cultured for Y. enterocolitica with highly selective media (Cefsulodin-Irgasan-Novobiocin [CIN] agar). Pathologically, 44 of the patients had appendicitis and 6 patients had normal appendices. Four of the 44 patients (9.1%) with appendicitis were found to be culture positive for Y. enterocolitica, while it was recovered from none of the normal appendices. This indicates that Y. enterocolitica may represent the major pathogen in acute appendicitis in a small, but distinct, portion of indigent patients within Los Angeles County as it does elsewhere in the world.
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PMID:The role of Yersinia enterocolitica in appendicitis in the southwestern United States. 174 91

In cases of clinical suspicion of an acute appendicitis sonography uncovers another disease as the real cause of the symptoms in about one-quarter of such cases. Bacterial ileocaecitis is most frequently diagnosed (11.6% of N = 786). In special bacteriological stool cultures, Yersinia enterocolitica and Campylobacter jejuni were identified, whereas Salmonella enteritidis was a rarer finding. The typical sonographic manifestation of bacterial ileocaecitis compared against Crohn's disease of the ileocaecal region is described. These two diseases can be differentiated against each other by means of sonography; likewise, it is also possible to distinguish them from appendicitis. Since stool cultures--which are not always prepared if diarrhoea is only mild or completely absent--are received relatively late in acute cases, knowledge of the sonographic manifestation of bacterial ileo caecitis can help save many an unnecessary laparotomy.
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PMID:[Bacterial ileocecitis: a "new" disease]. 179 86

786 patients with suspected acute appendicitis or appendiceal mass were examined by ultrasonography to distinguish appendicitis from bacterial enteritis. 533 of these patients were described before. In 91 (11.6%) ultrasonography revealed the characteristic picture associated with bacterial enteritis of the ileocaecal region-enlarged mesenteric lymph nodes and mural thickening of the terminal ileum and caecum--but no image of an inflamed appendix. In 64 of these a bacterial infection was confirmed (Yersinia enterocolitica in 28, Campylobacter jejuni in 24, Salmonella enteritidis in 11, Yersinia pseudotuberculosis in one). In the other 27, bacteriological tests were negative (17) or not performed (10). Only 34 of 91 had diarrhoea. Six of the 91 patients underwent surgery, in all of them the removed appendix was normal. The other 85 patients recovered with conservative treatment. In 38 a planned appendicectomy was cancelled because of the sonographic findings. Bacterial enteritis limited to the ileocaecal region (bacterial ileocecitis) appears to be responsible for an appreciable number of unnecessary appendicectomies. It has characteristic sonographic features which distinguish it from appendicitis.
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PMID:[Bacterial ileocecitis, a "new" disease]. 195 44

The article is the result of the joint work of a surgeon and a specialist in infectious diseases and is based on the results of treatment of 307 patients with the abdominal form of Yersinia infection Acute appendicitis was diagnosed in 73 (23.8%) of them. The abdominal form of Yersinia infection is encountered frequently among children. The authors analyse the clinical picture of acute appendicitis in patients with Yersinia infection, the time between the onset of the disease and the patient's call for the doctor, the dependence of the histologic findings in the examined removed vermiform processes on the duration of the disease, and the results of surgery. The difficulties in making the diagnosis of acute appendicitis in patients with yersinosis and concomitant mesadenitis and terminal ileitis are discussed. It is concluded that laparoscopy is advisable in doubtful clinical signs of acute appendicitis in patients with Yersinia infection due to the high frequency of destructive forms (77.9%). The average duration of in-patient treatment of persons with acute appendicitis and Yersinia infection was 4.8 days. The positive results of treatment are attributed to timely prescription of specific antibacterial therapy--the prescription of chloramphenicol from the moment that the diagnosis of yersinosis was established.
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PMID:[Acute appendicitis in patients with Yersinia infection]. 214 95

Recent work by epidemiologists and microbiologists has uncovered several hitherto unrecognized food-borne bacterial pathogens of public health significance. One of these, Listeria monocytogenes, has attracted considerable attention because of two major cheese-related outbreaks of listeriosis that were characterized by cases of meningitis, abortion, and perinatal septicemia. Thus far, L. monocytogenes has been responsible for well over 300 reported cases of food-borne listeriosis, including about 100 deaths, and has cost the dairy industry alone more than 66 million dollars as a result of product recalls. The ability of L. monocytogenes to grow at refrigeration temperatures, coupled with appearance of the pathogen in raw and processed meats, as well as poultry, vegetables, and seafood, makes this bacterium a serious threat to susceptible consumers and to the entire food industry. Yersinia enterocolitica, another psychrotrophic food-borne pathogen of recent concern, was linked to several outbreaks of yersiniosis associated with consumption of both raw and pasteurized milk, as well as contaminated water. Food-borne infections involving Y. enterocolitica typically result in enterocolitis, which may be mistaken for acute appendicitis. Unfortunately, inadvertent removal of healthy appendixes from victims of food-borne yersiniosis is all too common. Although known for many years, Campylobacter jejuni has only recently been recognized as a food-borne pathogen and a leading cause of gastroenteritis in the United States. Notable outbreaks of campylobacteriosis linked to consumption of raw milk, cake icing, eggs, poultry, and beef have underscored the need for thorough cooking and proper handling of raw products.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:"New" food-borne pathogens of public health significance. 250 76

533 consecutive patients with suspected acute appendicitis or appendiceal mass were examined by ultrasonography to distinguish acute appendicitis from bacterial enteritis. In 61 (11.4%) ultrasonography revealed the characteristic picture associated with bacterial enteritis of the ileocaecal region--enlarged mesenteric lymph nodes and mural thickening of the terminal ileum and caecum--but no image of the appendix. In 41 of these a bacterial infection was confirmed: infection due to Yersinia enterocolitica in 21, Campylobacter jejuni in 15, Salmonella B in 3, Salmonella C in 1, and Yersinia pseudotuberculosis in 1. In the other 20 bacteriological tests were negative (10) or not done (10). Oral barium studies, done in 15 patients, showed thickening of the terminal ileum in all of them. Only 22 of the 61 patients had diarrhoea. Yersinia enteritis clinically simulated an appendiceal mass in 17 of 22 patients, 6 of the 61 patients underwent surgery, and in all of them the appendix removed was normal. The other 55 patients recovered with conservative treatment. In 26 a planned appendicectomy was cancelled because of the sonographic findings. Bacterial enteritis limited to the ileocaecal region (bacterial ileocaecitis) seems to be responsible for an appreciable number of unnecessary appendicetomies. It has characteristic sonographic features that distinguish it from appendicitis.
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PMID:Incidence and sonographic diagnosis of bacterial ileocaecitis masquerading as appendicitis. 197 35


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