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Causative role ofYersinia and other enteric pathogens in the appendicular syndrome

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Abstract

In 2,861 consecutive patients undergoing appendicectomy for clinically suspected appendicitis an enteric pathogen was isolated from the appendix in almost 7 % using an optimal combination of culture media. The pathogenicYersinia enterocolitica serotypes 03 and 09 predominated (3.6 %), followed byCampylobacter and nontyphoidSalmonella. The same pathogen was isolated from the stool in 72.5 % of patients with a culture-positive appendix and in 84.1 % of those positive for a pathogenicYersinia. Conversely, no pathogenicYersinia were isolated in 326 gynaecologic control patients, in whom a normal appendix was removed. No frank appendicitis but mesenteric adenitis and/or terminal ileitis were found in 62.3 % of 138 patients with a culture positive appendix, and in 74.6 % of those positive for a pathogenicYersinia. Histologic findings available in 135 patients showed acute suppurative appendicitis in only six (4.5 %) patients, and in only one of 73 (1.4 %) positive for a pathogenicYersinia. In contrast, 46.8 % of a group of 345 culture-negative appendices showed acute inflammation. A positive stool culture in a patient with suspected appendicitis, if consistent with sonographic and clinical findings, should be taken as strong evidence against the presence of true appendicitis.

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Authors and Affiliations

  1. Imelda Hospital, 2830, Bonheiden, Belgium

    R. Van Noyen, R. Selderslaghs & J. Bekaert

  2. Department of Microbiology, St. Luc University Hospital, 1200, Brussels, Belgium

    G. Wauters

  3. Department of Microbiology, St. Raphael University Hospital, Kapucijnenvoer 33, 3000, Leuven, Belgium

    J. Vandepitte

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  1. R. Van Noyen
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  2. R. Selderslaghs
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  3. J. Bekaert
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  4. G. Wauters
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  5. J. Vandepitte
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Van Noyen, R., Selderslaghs, R., Bekaert, J. et al. Causative role ofYersinia and other enteric pathogens in the appendicular syndrome. Eur. J. Clin. Microbiol. Infect. Dis. 10, 735–741 (1991). https://doi.org/10.1007/BF01972498

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