Related Experiment Video
Updated: Sep 9, 2025
Culture Methods to Determine the Limit of Detection and Survival in Transport Media of Campylobacter Jejuni in Human Fecal Specimens
Published on: March 10, 2020
Campylobacter infection presenting as pseudo-appendicitis in children: identifying predictors for early diagnosis
Michael Schnapper1,2, Yaara Kahan2,3, Amir Klivitsky2,4
1Department of Pediatrics, E. Wolfson Medical Center, Holon, Israel.
Insights
Campylobacter enteritis can mimic appendicitis in children, leading to increased CT scans and antibiotic use. Key predictors include fever, low white blood cell count, and diarrhea, aiding in early diagnosis.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Surgical Diagnostics
Background:
- Campylobacter enteritis can present with symptoms mimicking appendicitis in children, posing a diagnostic challenge.
- This presentation, termed pseudo-appendicitis, can lead to increased utilization of diagnostic imaging and treatments.
Purpose of the Study:
- To characterize Campylobacter enteritis presenting as pseudo-appendicitis in children.
- To identify distinguishing predictive factors for Campylobacter pseudo-appendicitis.
Main Methods:
- Retrospective multicenter study of children (<18 years) hospitalized for presumed appendicitis with confirmed Campylobacter infection (2014-2023).
- Cases of pseudo-appendicitis were matched with controls with confirmed appendicitis.
- Multivariable logistic regression analysis was used to identify predictors.
Main Results:
- Fifty-five pseudo-appendicitis cases were compared to 110 appendicitis cases.
- Higher rates of computed-tomography (CT) scans (38% vs. 20%) and broad-spectrum antibiotic administration (34.5% vs. 0%) were observed in the pseudo-appendicitis group.
- Independent predictors for pseudo-appendicitis included fever, WBC <12,000/μl, sonographic signs of mesenteric lymphadenopathy/ileocolitis, absence of sonographic appendicitis signs, diarrhea, and age >14 years.
Conclusions:
- Campylobacter pseudo-appendicitis leads to significant diagnostic challenges, including increased CT imaging and unnecessary antibiotic use.
- Identifying specific predictors can help clinicians suspect Campylobacter enteritis in cases of suspected appendicitis.
- Early molecular diagnosis and improved patient care can be facilitated by recognizing these predictors.
Aims:
To characterize Campylobacter enteritis presenting as pseudo-appendicitis and identify distinguishing predicting factors.
Methods:
This retrospective multicentre study included all children <18 years with confirmed Campylobacter infection, hospitalized from 2014 to 2023 for presumed appendicitis (pseudo-appendicitis group). Each case was matched with 2 controls with confirmed appendicitis. Multivariable logistic regression analysis was conducted to determine the potential predictors for pseudo-appendicitis.
Results:
Fifty-five cases of pseudo-appendicitis were compared with 110 cases of appendicitis. The rate of peritoneal signs was similar between the two groups (78.2% vs. 75.5%, P = 0.07). Computed-tomography (CT) scans were performed nearly twice as often in the pseudo-appendicitis group (38% vs. 20%, P = 0.01). Broad-spectrum antibiotics were administered to 19 (34.5%) of patients with pseudo-appendicitis and none had surgery. Independent predictors of pseudo-appendicitis included: history of fever (OR: 17.2, 95% CI: 4.7-62.9, P < 0.01), WBC <12,000/μl (OR: 9.6, 95% CI: 2.9-31, P < 0.01), sonographic signs of enlarged mesenteric lymphadenopathy and/or ileocolitis (OR:5.8, 95% CI:1.8-18.6, P = 0.03), no sonographic sign of appendicitis (OR: -5.8, 95% CI: 1.3-25, P = 0.02), diarrhea (OR: 3.7, 95% CI:1.2-11.3, P = 0.02), and age >14 years (OR:3.3, 95% CI:0.91-12, P = 0.06).
Conclusion:
The diagnostic challenge of Campylobacter pseudo-appendicitis notably led to high rates of CT imaging and unnecessary broad-spectrum antibiotic administration. We identified predictors that may prompt clinicians to consider Campylobacter enteritis in selected cases of suspected appendicitis, potentially encouraging early molecular diagnosis and improving patient care.
More Related Videos
05:34Author Spotlight: Development of an Enhanced Protocol for Rapid and Accurate Isolation of Campylobacter from Food Products
Published on: February 23, 2024
08:51Murine Appendectomy Model of Chronic Colitis Associated Colorectal Cancer by Precise Localization of Caecal Patch
Published on: August 24, 2019
Related Concept Videos
01:22Appendicitis-I: Introduction
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
01:28Acute Pyelonephritis II: Diagnostic Studies and Management