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Eduardo Sandoval, Muhammad Nazim, Ruba A. Halloush, Faisal A. Khasawneh, A 16-Year-Old Female With Right Lower Quadrant Abdominal Pain, Clinical Infectious Diseases, Volume 58, Issue 8, 15 April 2014, Pages 1194–1195, https://doi.org/10.1093/cid/ciu008
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Extract
(See page 1129 for the Photo Quiz.)
Diagnosis: Enterobius vermicularis appendicitis.
The appendectomy specimen showed an intraluminal parasite with lateral alae characteristic for Enterobius vermicularis (Figures 1 and 2). The appendix showed submucosal lymphoid hyperplasia but no acute inflammation. Postoperatively, the patient and her family members received a course of albendazole.
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Appendicitis is the most common abdominal surgical emergency [1]. Appendectomy is not always the final cure for this condition and some specific postoperative treatment might be warranted. Fecaliths and submucosal inflammation, believed to be caused by viruses, account for 80%–95% of cases [1]. Less common causes for inflammation of the vermiform appendix include foreign bodies, neoplasm, and inspissated barium from radiological studies. Fruit seeds, parasites, and calculi are considered foreign bodies and account for about 4% of all cases of appendicitis.
Parasitic appendicitis requires a high index of suspicion and can easily be overlooked in low-prevalence regions [2]. It is usually diagnosed intraoperatively or on histopathological examination. The most commonly reported causative parasites are E. vermicularis, Ascaris lumbricoides, Entamoeba histolytica, and Giardia species [2].
