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Perforated appendicitis in a 4-month-old infant

Y S Ko¹, L H Lin, C S Huang

¹Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan, R.O.C.

Zhonghua Minguo Xiao Er Ke Yi Xue Hui Za Zhi [Journal]. Zhonghua Minguo Xiao Er Ke Yi Xue Hui

|July 1, 1996

Summary

Infantile appendicitis, though rare, presents diagnostic challenges and often leads to perforation. Early recognition and prompt surgical intervention are crucial for favorable outcomes in infants.

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Area of Science:

Pediatric Surgery
Gastroenterology
Infectious Diseases

Background:

Appendicitis in infants is uncommon.
Infantile appendicitis frequently presents with perforation and peritonitis.
Clinical manifestations are often nonspecific, complicating diagnosis.

Observation:

A 4-month-old infant presented with poor feeding and abdominal distention.
Initial labs showed normal leukocyte counts but markedly elevated C-reactive protein.
Progressive distention, bilious vomiting, and imaging findings suggested intestinal perforation.

Findings:

Emergency laparotomy revealed perforated appendicitis with generalized peritonitis.
Pseudomonas aeruginosa was identified, sensitive only to Ceftazidime.
The infant recovered after a 2-week course of triple antibiotics.

Implications:

This case highlights the diagnostic difficulties of appendicitis in very young infants.
Prompt surgical management is vital for perforated appendicitis in neonates and infants.
Aggressive antibiotic therapy targeting resistant organisms is essential for managing peritonitis.

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