Causative Role of Yersinia and Other Enteric Pathogens in the Appendicular Syndrome

Vannoyen, R.;Selderslaghs, R.;Bekaert, J.;Wauters, Georges;Vandepitte, J.
(1991) European Journal of Clinical Microbiology & Infectious Diseases : an international journal on pathogenesis, diagnosis, epidemiology, therapy, and prevention of infectious diseases — Vol. 10, n° 9, p. 735-741 (1991)

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Authors
  • Vannoyen, R.
    Author
  • Selderslaghs, R.
    Author
  • Bekaert, J.
    Author
  • Wauters, GeorgesUCLouvain
    Author
  • Vandepitte, J.
    Author
Abstract
In 2,861 consecutive patients undergoing appendicectomy for clinically suspected appendicitis an enteric pathogen was isolated from the appendix in almost 7 % using an optimal combination of culture media. The pathogenic Yersinia enterocolitica serotypes 03 and 09 predominated (3.6 %), followed by Campylobacter and nontyphoid Salmonella. The same pathogen was isolated from the stool in 72.5 % of patients with a culture-positive appendix and in 84.1 % of those positive for a pathogenic Yersinia. Conversely, no pathogenic Yersinia were isolated in 326 gynaecologic control patients, in whom a normal appendix was removed. No frank appendicitis but mesenteric adenitis and/or terminal ileitis were found in 62.3 % of 138 patients with a culture positive appendix, and in 74.6 % of those positive for a pathogenic Yersinia Histologic findings available in 135 patients showed acute suppurative appendicitis in only six (4.5 %) patients, and in only one of 73 (1.4 %) positive for a pathogenic Yersinia. In contrast, 46.8 % of a group of 345 culture-negative appendices showed acute inflammation. A positive stool culture in a patient with suspected appendicitis, if consistent with sonographic and clinical findings, should be taken as strong evidence against the presence of true appendicitis.
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Vannoyen, R., Selderslaghs, R., Bekaert, J., Wauters, G., & Vandepitte, J. (1991). Causative Role of Yersinia and Other Enteric Pathogens in the Appendicular Syndrome. European Journal of Clinical Microbiology & Infectious Diseases : an international journal on pathogenesis, diagnosis, epidemiology, therapy, and prevention of infectious diseases, 10(9), 735-741. https://doi.org/10.1007/BF01972498 (Original work published 1991)