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[Appendicitis: microbial interactions and new pathogens]

D Dionisio1, A Belli, A Dionisio

  • 1Divisione Malattie infettive, Policlinico Careggi, Firenze.

Insights

This review details microbial causes of appendicitis, highlighting common and rare agents. Yersinia enterocolitica is a significant bacterial cause, identified in 3.8% of Florentine appendicitis cases.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Gastroenterology

Background:

  • Appendicitis is commonly caused by autochthonous microorganisms.
  • Exogenous agents, including bacteria, viruses, fungi, protozoa, and helminths, can also cause appendicitis.
  • The specific microbial etiology of appendicitis requires comprehensive investigation.

Purpose of the Study:

  • To conduct an exhaustive review of microbial agents responsible for appendicitis.
  • To analyze the pathogenetic interactions of common and less common microbial agents.
  • To evaluate the role of specific bacteria, such as Yersinia enterocolitica, in appendicitis.

Main Methods:

  • Literature review of microbial agents of appendicitis.
  • Analysis of personal research data on microbial isolates from inflamed appendices.
  • Bacteriological isolation and identification from surgical specimens.

Main Results:

  • Common autochthonous agents and their pathogenetic roles were analyzed.
  • Less common exogenous agents, including bacterial, viral, mycotic, protozoan, and helminthic agents, were detailed.
  • Yersinia enterocolitica was identified as a significant agent, implicated in 3% to 8% of cases, and isolated in 3.8% of Florentine patients.
  • The pathogenetic role of emerging bacteria like Buttiauxella agrestis, Aeromonas hydrophila, Arizona, and Streptococcus lactis was debated.

Conclusions:

  • Microbial agents play a crucial role in the pathogenesis of appendicitis.
  • Yersinia enterocolitica is a notable bacterial cause of appendicitis.
  • Further research is needed to elucidate the role of newly identified bacteria in appendicitis.

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