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首页> 外文期刊>Journal of Clinical Microbiology >Underestimated Amoebic Appendicitis among HIV-1-Infected Individuals in Japan
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Underestimated Amoebic Appendicitis among HIV-1-Infected Individuals in Japan

机译：在日本被HIV-1感染者中被低估的阿米巴性阑尾炎

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Entamoeba histolytica is not a common causative agent of acute appendicitis. However, amoebic appendicitis can sometimes be severe and life threatening, mainly due to a lack of awareness. Also, its frequency, clinical features, and pathogenesis remain unclear. The study subjects were HIV-1-infected individuals who presented with acute appendicitis and later underwent appendectomy at our hospital between 1996 and 2014. Formalin-fixed paraffin-embedded preserved appendix specimens were reexamined by periodic acid-Schiff (PAS) staining and PCR to identify undiagnosed amoebic appendicitis. Appendectomies were performed in 57 patients with acute appendicitis. The seroprevalence of E. histolytica was 33% (14/43) from the available stored sera. Based on the medical records, only 3 cases were clinically diagnosed as amoebic appendicitis, including 2 diagnosed at the time of appendectomy and 1 case diagnosed by rereview of the appendix after the development of postoperative complications. Retrospective analyses using PAS staining and PCR identified 3 and 3 more cases, respectively. Thus, E. histolytica infection was confirmed in 9 cases (15.8%) in the present study. Apart from a significantly higher leukocyte count in E. histolytica-positive patients than in negative patients (median, 13,760 versus 10,385 cells/μl, respectively, P = 0.02), there were no other differences in the clinical features of the PCR-positive and -negative groups. In conclusion, E. histolytica infection was confirmed in 9 (15.8%) of the appendicitis cases. However, only 3, including one diagnosed after intestinal perforation, were diagnosed before the present analyses. These results strongly suggest there is frequently a failure to detect trophozoites in routine examination, resulting in an underestimation of the incidence of amoebic appendicitis.
机译：溶组织性变形杆菌不是急性阑尾炎的常见病因。但是，阿米巴性阑尾炎有时可能很严重，并且可能危及生命，这主要是由于缺乏认识。而且，其频率，临床特征和发病机理仍不清楚。研究对象为1996年至2014年间感染HIV-1的急性阑尾炎患者，后来在我院接受了阑尾切除术。福尔马林固定石蜡包埋的阑尾标本通过高碘酸席夫（PAS）染色和PCR进行重新检查。鉴别未诊断的阿米巴性阑尾炎。在57例急性阑尾炎患者中进行了阑尾切除术。从可用的存储血清中，溶组织性大肠杆菌的血清阳性率为33％（14/43）。根据医疗记录，仅3例临床诊断为阿米巴性阑尾炎，其中2例在阑尾切除术时确诊，1例在术后出现并发症后经阑尾复查确诊。使用PAS染色和PCR的回顾性分析分别确定了3例和3例。因此，在本研究中证实了9例（15.8％）的溶组织性大肠杆菌感染。除了溶组织性大肠杆菌阳性患者的白细胞计数显着高于阴性患者（中位数分别为13,760和10,385个细胞/μl， P = 0.02）外，临床上没有其他差异PCR阳性和阴性组的特征。总之，在9例（15.8％）阑尾炎病例中确认了溶组织性大肠杆菌感染。但是，在本分析之前仅诊断出3例，包括在肠穿孔后诊断出的一种。这些结果强烈暗示在常规检查中经常无法检测到滋养体，导致低估了阿米巴性阑尾炎的发生率。

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