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[Association of streptococcal pharyngitis with complicated appendicitis]

P Lê1, A L Zeiter, Y Ramaheriarison

  • 1Service de chirurgie générale, centre hospitalier de l'agglomération montargoise, 658, rue des Bourgoins, BP 725, 45207 Montargis, France. le.pierre@wanadoo.fr

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|August 19, 2007
PubMed

Insights

Pediatric appendicitis can mimic other conditions, presenting a diagnostic challenge. This case highlights how streptococcal pharyngitis can mislead clinicians to suspect mesenteric adenitis over appendicitis.

Area of Science:

  • Pediatric Surgery
  • Infectious Diseases
  • Diagnostic Imaging

Background:

  • Streptococcal pharyngitis commonly presents with throat pain and fever.
  • Right lower abdominal quadrant pain in children is often attributed to mesenteric adenitis, especially when pharyngitis is present.

Observation:

  • A 6-year-old child presented with acute right lower quadrant abdominal pain and fever.
  • Clinical examination revealed pharyngeal erythema and abdominal tenderness; a rapid Strep test was positive.
  • Abdominal ultrasound indicated signs consistent with appendicitis.

Findings:

  • The child underwent surgery for complicated appendicitis, despite initial suspicion of mesenteric adenitis due to concurrent pharyngitis.
  • This case underscores the potential for misdiagnosis when pharyngitis symptoms overlap with appendiceal pain.

Implications:

  • Clinicians must maintain a high index of suspicion for appendicitis in children with right lower quadrant pain, even with concurrent pharyngitis.
  • Diagnostic imaging, such as ultrasound, is crucial in differentiating appendicitis from mesenteric adenitis in such cases.
  • Recognizing this misleading association can prevent delayed diagnosis and treatment of pediatric appendicitis.
Abstract

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