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Acute appendicitis in patients with AIDS/HIV infection
1Department of Surgery, Mount Sinai Medical Center, New York, New York 10029.
American Journal of Surgery
|July 1, 1991
Summary
Patients with acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection presenting with appendicitis often lack typical elevated white blood cell counts. Early diagnosis and surgical intervention, including laparoscopy, are crucial and safe for these individuals.
Area of Science:
- Surgery
- Infectious Diseases
- Immunology
Background:
- Appendicitis in patients with acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection presents unique diagnostic challenges.
- Leukocytosis, a common indicator of appendicitis, is often absent in immunocompromised individuals.
Purpose of the Study:
- To analyze the clinical presentation, diagnostic methods, and surgical outcomes of appendicitis in patients with AIDS/HIV.
- To evaluate the safety and efficacy of appendectomy in this patient population.
Main Methods:
- Retrospective review of nine patients with AIDS/HIV who underwent surgery for acute appendicitis.
- Analysis of preoperative laboratory values, diagnostic procedures (including laparoscopy), surgical findings, and postoperative outcomes.
Main Results:
- Six of nine patients lacked preoperative leukocytosis.
- Four patients had perforated appendices.
- Diagnostic laparoscopy facilitated earlier diagnosis in two cases.
- All patients underwent appendectomy without significant increase in morbidity or mortality.
- Seven patients experienced persistent postoperative fever.
Conclusions:
- Appendicitis in AIDS/HIV patients may not present with typical leukocytosis, necessitating a high index of suspicion.
- Diagnostic laparoscopy can improve diagnostic accuracy and expedite treatment.
- Appendectomy is a safe and effective treatment for appendicitis in patients with AIDS/HIV, even with atypical presentations and postoperative fever.