Salmonella ileocecal lymphadenitis masquerading as appendicitis

doi:10.1016/S0022-3468(86)80210-X

Journal of Pediatric Surgery

Volume 21, Issue 4, April 1986, Pages 377-378

https://doi.org/10.1016/S0022-3468(86)80210-X Get rights and content

Salmonella infection requiring surgical intervention is rare. A case of localized ileocecal lymphadenitis due to Salmonella newport is reported. A review of the literature demonstrates that this is one of a spectrum of conditions of tissue infection by Salmonella in the ileocecal region. The outlook is good, and no untoward effects have arisen from surgery so that awareness of this condition should not alter the operative approach to a patient with a clinical diagnosis of acute appendicitis.

References (8)

Center for Disease Control. Salmonella surveillance. Annual Summary 1977 HEW Publication No. (CDC)...
SeligmannE et al.
Salmonella infections: Report of 37 cases observed at Beth Israel, New York, in past 4 years
Ann Int Med
(1944)
MayerJB
Appendicitis paratyphosa
Mitt a d Grenzeb d Med u Chir
(1934)
RubensteinAO et al.
Salmonella appendicitis
Am J Med Sci
(1945)

There are more references available in the full text version of this article.

Cited by (20)

Acute abdomen caused by Salmonella typhimurium infection in children
2001, Journal of Pediatric Surgery
Citation Excerpt :
Salmonella spp. also have been isolated as causes of osteomyelitis and brain abscess, but such findings are rare.2,3 Salmonella spp. also can cause true appendicitis or appendicitislike symptoms.5-10 Overall, the spectrum of associated pathology is broad, ranging from lymphoid hyperplasia of the appendix to lymphadenitis of adjacent nodes, and from ileitis with or without appendicitis to suppurative appendicitis.13,14
Salmonella spp. infections can be particularly challenging when they manifest as acute abdominal problems and lead to emergency surgery. Examples of such serious conditions are Salmonella-related intestinal perforation, gallbladder involvement, salpingitis, and peritonitis. Mesenteric lymphadenitis associated with Salmonella typhimurium mimics acute appendicitis and can make it difficult to establish a timely and definitive diagnosis in young patients who present with right lower abdominal pain. Paralytic ileus is a fairly common manifestation of Salmonella infection at all ages, but complete intestinal obstruction requiring surgical intervention is very rare. Because of the nature of the diagnostic process, a significant number of patients with Salmonella infection present with acute abdomen and undergo needless operations. This report describes the cases of 2 pediatric patients who underwent surgery to address persistent pain in the right lower abdominal quadrant and complete intestinal obstruction, respectively. The first patient had inflamed mesenteric lymph nodes that caused appendicitislike symptoms, and the second had dense adhesions between the mesentery and the terminal segments of the ileum that led to intestinal blockage. Serology results showed that both patients' titers for BO (“B and O agglutinating [BO]”) antibodies rose to 1:640 in the week after their admission to hospital, a pattern and level that is indicative of S typhimurium infection. J Pediatr Surg 36:1849-1852. Copyright © 2001 by W.B. Saunders Company.
Salmonella infection in pediatrics
1992, Medecine et Maladies Infectieuses
La moitié des infections à salmonelles surviennent chez l'enfant, 50 % d'entre elles avant l'âge de deux ans. Les grandes épidémies de crèche ou d'hôpital à prédominance estivale ont disparu, remplacées par une infestation régulière dans laquelle Salmonella typhimurium est toujours au premier plan. Les infections de l'enfant sont remarquables par la fréquence des bactériémies qui sur certains terrains (déficit immunitaire, drépanocytose, nouveau-né et jeune nourrisson) sont susceptibles de se compliquer (méningites, ostéo-arthrites). L'enfant à risque doit donc être traité de façon systématique par les mêmes antibiotiques que chez l'adulte, à l'exception des fluoroquinolones.
Fifty per cent of Salmonella infectious occur in childhood and especially before the age of two years (50 %). In industrialized countries, there are no more outbreaks in pediatrics wards or day-care centers. Infections are observed all the year and S. typhimurium is always the main serotype. A striking feature in childhood is the high frequency of bacteriemias. Complications (meningitis, joint or bone infections) occur in “high-risk” children (neo-nates and infants, sickle cell disease, immunodeficiencies). Systematic treatment in this children is advocated with the same antibiotics as in adults, except for fluoroquinolones.
INCIDENCE AND SONOGRAPHIC DIAGNOSIS OF BACTERIAL ILEOCAECITIS MASQUERADING AS APPENDICITIS
1989, The Lancet
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, Campylobacterjejuni 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.
Samonella typhi infection-related appendicitis: A case report
2021, World Journal of Clinical Cases
On-treatment improvement of an emerging psychosomatic depressive disorder among salmonella carriers: A multicenter experience from Egypt
2019, Infection and Drug Resistance
On-Treatment Improvement of an Emerging Psychosomatic Depressive Disorder among Salmonella Carriers: A Multicenter Experience from Egypt
2018, SSRN

View all citing articles on Scopus

¹: From the Division of Pediatric Surgery, Royal Alexandra Hospital for Children, Camperdown, Australia.

View full text

Salmonella ileocecal lymphadenitis masquerading as appendicitis

Salmonella infections: Report of 37 cases observed at Beth Israel, New York, in past 4 years

Ann Int Med

Appendicitis paratyphosa

Mitt a d Grenzeb d Med u Chir

Salmonella appendicitis

Am J Med Sci