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Unusual Pneumonia Mimic.

Joana Ricardo Pires¹, Maria José Moreira¹, Margarida Martins²

¹Internal Medicine Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal.

European Journal of Case Reports in Internal Medicine

|August 15, 2019

Summary

A rare subhepatic appendicitis case mimicked pneumonia, leading to sepsis. Early diagnosis of this rare appendix location is crucial for patient survival and preventing complications.

Keywords:

Appendicitis inflammatory lung injury sepsis subhepatic appendix

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Area of Science:

Gastroenterology
Emergency Medicine
Radiology

Background:

Atypical presentations of appendicitis can mimic other conditions, delaying diagnosis and treatment.
Subhepatic appendicitis is a rare anatomical variant, often presenting diagnostic challenges.
Sepsis and acute inflammatory lung injury can arise from intra-abdominal infections.

Purpose of the Study:

To report a case of perforated subhepatic appendicitis presenting as sepsis and pneumonia.
To highlight the diagnostic challenges posed by atypical appendix locations.
To emphasize the importance of considering anatomical variants in sepsis management.

Main Methods:

Case report of a 55-year-old male with sepsis and hypoxemia.
Initial diagnosis of community-acquired pneumonia based on chest X-ray.
Laparoscopy revealed perforated subhepatic appendicitis as the source of infection.

Main Results:

The patient initially presented with symptoms mimicking pneumonia, leading to delayed abdominal evaluation.
Exploratory laparoscopy identified a perforated subhepatic appendix as the cause of sepsis.
Prompt source control and antibiotic treatment are vital for sepsis survival.

Conclusions:

Subhepatic appendicitis can present atypically, mimicking common conditions like pneumonia.
A high index of suspicion for anatomical variants is essential for diagnosing appendicitis.
Effective sepsis management requires controlling the source of infection.