Molecular detection of Campylobacter jejuni in archival cases of acute appendicitis

Afectación del apéndice cecal y simulación de una apendicitis aguda en un cuadro intestinal por Campylobacter jejuni

“…El dolor abdominal grave puede simular una peritonitis aguda y, en el caso de adolescentes y adultos jóvenes, llegar a simular una apendicitis aguda 6 , o incluso ser causante de la misma, como fue en nuestro caso. El estudio de Campbell et al 7 demuestra que, hasta el en 22% de las apendicitis de su población analizada mediante reacción en cadena de la polimerasa, se detectó la presencia de Campylobacter jejuni, con una inflamación limitada a mucosa y submucosa sin supuración transmural 7 . Estas descripciones son histológicamente similares al patrón de la "colitis activa focal" visto a menudo en los casos de colitis bacteriana aguda, autolimitada, muchos de los cuales se deben a la infección por Campylobacter jejuni [4][5][6] .…”

“…Por otra parte, el dolor abdominal puede ser intenso y llegar a confundirse con un cuadro peritoneal agudo [5][6][7] .…”

Epidemiologic Features of Appendicitis

“…Dengue, Influenza, Epstein-Barr, Rota and Cytomegaloviruses has been linked to appendicitis (Alder, et al, 2010;Boon-Siang, et al, 2006;Livingston, et al, 2007;Thalayasingam, 1985). Similarly, bacteria such as Campylobacter, Brucella and Salmonella (Campbell LK et al, 2006;Chan, et al, 1983;Lau, et al, 2005;Pourbagher, et al, 2006) as well as parasites like Entameba histolytica, Schistosoma mansonii/japonicum, and Enterobius vermicularis (Andrade, et al, 2007;Elazary, et al 2005;Gali, et al, 2008;Gotohda, et al, 2000;Isik, et al, 2007;McCarthy, et al, 2002;Sah & Bhadani, 2006;Terada, 2009) have been isolated in specimens or indirectly implicated in the pathogenesis of appendicitis. These pathogens are thought to cause appendicitis by invading the lamina propria and inciting edema to cause obstruction of the narrow lumen of the appendix to result in appendicitis.…”

“…In a more remarkable study comprising of 772 women in the state of Illinois undergoing laparoscopic examination for primary infertility who also underwent incidental appendectomy, 585 (75%) had histologic evidence of superficial a p p e n d i c i t i s e v e n t h o u g h n o n e o f t h e m p r esented with features that would suggest appendicitis preoperatively (Song, et al, 2009). There are suggestions that this superficial inflammation of the appendix may be an extension of colitis caused by bacteria such as salmonella and campylobacter into the lumen of the appendix (Campbell LK et al, 2006;Chan, et al, 1983;Lau, et al, 2005). Without agreement on the categorization of superficial appendicitis the basis for comparative epidemiological studies of appendicitis is shaky.…”

Global imaging will widen epidemiologic knowledge of appendicitis by perceiving the dilated crypts in archival collections worldwide

“…Worldwide problems concern the epidemiology of appendicitis undoubtedly [1,2]. In order to improve on a better knowledge of it, Howie [3] stressed the importance of including the "limited" form of it in classifications!…”