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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

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

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

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

The authors presented the results of clinical and x-ray investigation of 102 patients with epidemic pseudotuberculosis (EP). The diagnosis was established on the basis of epidemiological evidence and the results of clinical and serological investigation. The affection of the digestive organs was observed not only in the abdominal type of EP but also in its other types. X-ray examination of the digestive organs revealed terminal ileitis in 56.8% of the patients alongside with functional disorders. X-ray examination plays a certain role in the differential diagnosis of EP from other diseases of the ileocecal region, in particular from acute appendicitis.
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PMID:[Clinico-roentgenologic manifestations of intestinal lesions in pseudotuberculosis]. 274 22

In 194 patients presenting with acute abdominal pain from whom sequential serum samples were taken, the frequency of yersiniosis, established serologically, was significantly higher (23%) than in 320 control subjects (2%). Yersiniosis occurred in 31% of patients with acute appendicitis. Acute-phase serum samples only, obtained in a further 307 patients, yielded a falsely low frequency of yersiniosis (4%). Y pseudotuberculosis was five times more common than Y enterocolitica, and Y pseudotuberculosis type IV was the most common serotype, accounting for 43% of Yersinia infections. Yersinia may play a more important part in the aetiology of acute abdominal pain, and particularly acute appendicitis, than has been previously appreciated. Antibody titres to both Y enterocolitica and Y pseudotuberculosis frequently rise late in infections causing abdominal pain. Consequently analysis of acute-phase serum samples alone leads to underdiagnosis of yersiniosis.
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PMID:Yersinia infection and acute abdominal pain. 288 Oct 83

Human enteric infection with Yersinia enterocolitica or Yersinia pseudotuberculosis may masquerade clinically as acute appendicitis but it is unusual for the appendix to be histologically inflamed. We report a case of Yersinia pseudotuberculosis infection in which acute appendicitis was present in the absence of terminal ileitis.
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PMID:Yersinia pseudotuberculosis with inflammation of the appendix: a case report. 330 14

In 352 patients who were hospitalized with symptoms of an acute appendicitis, Yersinia infection were determined in 18.2% of the cases by cultural and serological methods. Infections due to Y. enterocolitica (Y. e.) serovar 0:3 were approximately 6 times more frequent than those due to Y. e. serovar 0:9. Yersinia pseudotuberculosis (Y. pstbc.) could only be isolated in one patient from a mesenterial lymph node. In another case Yersinia serovar 0:6 could be isolated as well as Y. e. serovar 0:3. The majority of the infections were found in the age group 9-12 years. The incidence was highest in the summer months June-August.
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PMID:[Frequency and significance of infections due to Yersinia enterocolitica in "acute appendicitis" (author's transl)]. 703 57

Four out of 24 patients presenting as an emergency with acute non-specific abdominal pain showed serological evidence of infection with Yersinia pseudotuberculosis. Two out of 13 patients presenting with acute appendicitis during the same period also had evidence of Yersinia infection. Viral infection was present in only 1 patient in each group. Since it is rare to find antibodies to yersinia in healthy individuals, it seems likely that yersinia is a cause of some cases of non-specific abdominal pain. Viral infection does not appear to be an important aetiological factor in patients over 12 years of age.
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PMID:Yersinia and viruses in acute non-specific abdominal pain and appendicitis. 722 44

Pasteurella pseudotuberculosis has been considered a widespread animal pathogen for many years, but only within the last decade has its capacity to cause human disease been recognized. Two forms of human disease have been established-acute septicemia and mesenteric lymphadenitis. Because mesenteric adenitis is frequently indistinguishable from acute appendicitis, blood serum was obtained from 66 consecutive patients who underwent operation for appendicitis and was examined for agglutinins to seven serotype strains of P. pseudotuberculosis. Agglutinins were obtained in 21.2% of this series. Titres of over 1/100 were found in three of three cases of mesenteric lymphadenitis, one of 11 with no apparent disease, and one of 46 with appendicitis. P. pseudotuberculosis was isolated from a lymph node in the latter case. Two to four follow-up samples of sera in each of these five cases had increasing and then decreasing titres, indicative of active disease. Titres of 1/15 or less were found in five of the cases of appendicitis, in one case of salpingitis, and in three with no apparent disease. The occurrence of these nine cases with low titres may be indicative of previous contact with the organism.Human infection with P. pseudotuberculosis is not unusual in the Edmonton region and is responsible for at least some cases of mesenteric lymphadenitis.
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PMID:Pasteurella pseudotuberculosis infection in man. 1395 43


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