AB024. SOH25_AB_149. Concomitant positive viral nasal swabs and appendicitis: a case series
Paediatric Session

AB024. SOH25_AB_149. Concomitant positive viral nasal swabs and appendicitis: a case series

Eibhlín Burns Beattie1, Seoidín McKittrick2, Nicola Cullen2, Efthymios Koutroumanos2, Tara Connelly2

1Faculty of Education & Health Services, School of Medicine, University of Limerick, Garraun, Castletroy, Limerick, Ireland; 2Department of Surgery, University Hospital Limerick, Dooradoyle, Limerick, Ireland

Background: Mesenteric adenitis (MA) is a known sequelae of upper respiratory tract infections in children, and overlaps symptomatically with acute appendicitis (AA). Due to difficulty in differentiation of MA and AA, a nasal swab is done on many children presenting with acute abdominal pain and/or respiratory symptoms. A positive nasal swab is generally reassuring to distinguish between these diagnoses.

Methods: A retrospective review of operative records in emergency theatres over four years (from 1/06/2020 to 31/05/2024). Inclusion criteria were; paediatric patients less than 16 years old, underwent appendicectomy, had a positive nasal swab. Data collected included patient demographics, haematological results and histology reports and were analysed statistically using SPSS software.

Results: A total of 756 patients underwent appendicectomy during the study period. Fifteen (53.3% female, 46.7% male; mean age 10.9±3.2 years) had a positive nasal swab and appendicectomy. Infections included coronavirus disease 2019 (COVID-19) (n=7), rhinovirus (n=5), influenza A (n=1), respiratory syncytial virus (RSV) (n=1), and cryptosporidium (n=1). The majority (53%) were histologically proven appendicitis. Of these, white cell count (WCC), C-reactive protein (CRP), and neutrophils were increased in 25%, 75%, and 37% respectively. In those with histologically normal appendixes, only 16%, 33%, and 16% had increased WCC, CRP, and neutrophils (P=0.46, 0.31, 0.23 respectively). A statistically significant difference in viral presentations was observed between male and female patients (P=0.048).

Conclusions: Despite a small dataset, certain trends were noted. There was no difference between virus type and histology. Those with appendicitis were older and more likely to have raised inflammatory markers. This study highlights the importance of considering dual pathologies and noting the high negative appendicectomy rate of 46%.

Keywords: Appendicectomy; inflammatory markers; mesenteric adenitis (MA); paediatrics; ultrasound

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab024
Cite this abstract as: Burns Beattie E, McKittrick S, Cullen N, Koutroumanos E, Connelly T. AB024. SOH25_AB_149. Concomitant positive viral nasal swabs and appendicitis: a case series. Mesentery Peritoneum 2025;9:AB024.

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