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Typhoid appendicitis and 'the man from Istanbul'

Angelina Mendos1, Sanjay A Pai1

  • 1Department of Pathology and Laboratory Medicine, Manipal Hospital Yeshwanthpur, Malleswaram, Bengaluru 560055, Karnataka, India.

The National Medical Journal of India
|July 11, 2022
PubMed

Insights

Typhoid appendicitis, a rare condition, was identified in a young female patient. Macrophage aggregates in the appendix suggest Salmonella Typhi infection, aiding diagnosis even without positive blood cultures.

Area of Science:

  • Pathology
  • Infectious Diseases
  • Microbiology

Background:

  • Typhoid fever is a systemic infection caused by Salmonella enterica serovar Typhi.
  • Appendicitis is a common surgical emergency, but typhoid appendicitis is rare.
  • Histopathological examination of appendectomy specimens is crucial for diagnosing abdominal pathologies.

Observation:

  • A 19-year-old female presented with symptoms suggestive of appendicitis.
  • Histopathological analysis of the surgically removed appendix revealed significant aggregates of macrophages within the mucosal and wall layers.
  • Blood cultures confirmed the presence of Salmonella enterica serovar Typhi.

Findings:

  • The appendix exhibited characteristic histopathological changes indicative of typhoid infection.
  • The presence of macrophages in the appendix is a key diagnostic indicator for typhoid fever.
  • Microbiological confirmation of Salmonella Typhi was obtained from blood cultures.

Implications:

  • Pathologists should consider typhoid fever in the differential diagnosis of appendicitis, especially when observing macrophage aggregates.
  • This case highlights the importance of integrating histopathology with clinical and microbiological data for accurate diagnosis.
  • Early and accurate diagnosis of typhoid appendicitis can prevent complications and guide appropriate treatment.

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