[Immunologic and bacteriologic study of severe acute appendicitis. Diagnostics and therapeutic considerations]

Acute appendicitis remains an up to date issue, being the most frequent cause of surgical acute abdomen round the globe. The complications that occurs creates important therapeutically difficulties. The study, based on 114 cases, had analyzed not only the pathogen flora (type, association, frequency of certain germs, the relation between them and different pathological lesion), but also the immune response of the organism to septic aggression. The microbiological tests from the lumen and bont of the appendix and also from peritoneal cavity showed monobacterial infection (11%) and pluribacterial infection (89%). Association between aerobes and anaerobes germs was identified in 85%. The most frequent germs identified were E. coli (87%) and Bacteroides (55%). We didn't identify germs with particular pathogenesis and the immune response had no malfunction. We can conclude that time factor is the main element in constituting of complications during acute appendicitis. A late diagnosis and also a late surgical intervention are the bases for the gravity of the pathogenic process.