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Appendiceal spirochaetosis in children.

Laurens J Westerman, Marguerite Ei Schipper, Herbert V Stel

  • 1Department of Medical Microbiology, University Medical Centre Utrecht, PO-box 85500, 3508 GA, Utrecht, The Netherlands. h.kusters@umcutrecht.nl.

Gut Pathogens
|December 17, 2013
PubMed
Summary

This study investigated intestinal spirochaetes in children

Area of Science:

  • Pediatric Surgery
  • Microbiology
  • Gastroenterology

Background:

  • Acute appendicitis is a common surgical emergency.
  • Pseudo-appendicitis, non-inflamed appendices, occur in up to 17% of cases.
  • Intestinal spirochaetes are found in some non-inflamed adult appendices, but prevalence in children is unknown.

Purpose of the Study:

  • To determine the association between pseudo-appendicitis and appendiceal spirochaetosis in children.
  • To investigate the role of intestinal spirochaetes in pediatric appendicitis.

Main Methods:

  • Analysis of archival appendix specimens from pediatric patients (<18 years).
  • Histopathological examination using H&E staining.
  • Spirochaete-specific immunohistochemistry and real-time PCR for Brachyspira species.

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Main Results:

  • Five out of 142 appendices tested positive for spirochaetes.
  • Positive cases were identified in the acute appendicitis (n=1), pseudo-appendicitis (n=2), and control (n=2) groups.
  • All positive cases occurred in male patients.

Conclusions:

  • The study found no evidence to support a role of Brachyspira species infection in the cause of acute appendicitis in children.
  • Appendiceal spirochaetosis was detected in pediatric appendices, but not significantly associated with appendicitis or pseudo-appendicitis.