Strongyloides appendicitis: unusual etiology in two siblings with chronic abdominal pain

Appendicitis is one of the most common causes of acute surgical disease in children and young adults. Parasites, however, are one of the uncommon etiologies. An 8-year-old girl and her 7-year-old sister presented with more than 2 months of chronic abdominal pain that became worse over a 1-week perio...

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Bibliographic Details
Published in:Journal of pediatric surgery 2003-09, Vol.38 (9), p.E8-E10
Main Authors: Komenaka, Ian K, Wu, George C.H, Lazar, Eric L, Cohen, Jason A
Format: Article
Language:English
Subjects:
Abdominal Pain - etiology
Animals
Appendicitis - diagnosis
Appendicitis - parasitology
Child
chronic abdominal pain
Chronic Disease
Female
Humans
parasite
Siblings
Strongyloides - isolation & purification
Strongyloides appendicitis
Strongyloidiasis - diagnosis
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Summary:Appendicitis is one of the most common causes of acute surgical disease in children and young adults. Parasites, however, are one of the uncommon etiologies. An 8-year-old girl and her 7-year-old sister presented with more than 2 months of chronic abdominal pain that became worse over a 1-week period before presentation. The 2 sisters presented 1 month apart. Both had similar symptomatology and physical examination findings. At operation, the surgical findings included an inflamed appendix with a cross section of the parasite Strongyloides. Strongyloides appendicitis has occurred almost exclusively in areas endemic to the parasite. Its environment is more common outside the United States but occasionally is seen in the Southeast region and in institutionalized individuals. The presentation of acute exacerbation of chronic abdominal pain coupled with the pathologic finding of Strongyloides in an acutely inflamed appendix, should alert the clinician of other possible cases. This increased index of suspicion will allow more prompt diagnosis and help avoid the morbidity of delayed operation.
ISSN:0022-3468
1531-5037
DOI:10.1016/S0022-3468(03)00415-9