Measles and appendicitis

Area of Science:

• Pediatrics
• Infectious Diseases
• Gastroenterology

Background:

• Measles (rubeola) is a highly contagious viral illness.
• Right lower quadrant pain can present with various differential diagnoses, including appendicitis.

Observation:

• Two pediatric patients presented with prodromal measles and right lower quadrant pain.
• One patient underwent appendectomy, revealing Warthin-Finkeldey giant cells in the appendix.
• The second patient's pain resolved spontaneously, with a measles rash appearing later.

Findings:

• Histologic examination of the appendix identified Warthin-Finkeldey giant cells, indicative of measles.
• The presence of these cells allowed for prediction of the measles rash.
• The association between measles and appendicitis symptoms was observed.

Implications:

• The findings highlight a potential diagnostic challenge in differentiating measles prodrome from appendicitis.
• Surgeons must maintain a high index of suspicion for appendicitis despite concurrent measles symptoms.
• Early recognition and appropriate surgical intervention remain paramount for suspected appendicitis.