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Arch Surg. 2007;142(5):488.

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Answer: Perforated Schistosomal Appendicitis

This patient had schistosomal appendicitis. Appendiceal cryptosporidiosis has been reported in 1 case of a man who was human immunodeficiency virus positive and presenting with signs and symptoms of appendicitis.¹ He was later found to have well-developed cryptosporidiosis. In any elderly patient presenting with signs and symptoms of appendicitis, the diagnosis of cancer must be considered. A recent article² showed that 24% of patients aged 60 years or older had appendiceal cancer when presenting with signs and symptoms of acute appendicitis.

Schistosomiasis affects approximately 200 million people in 74 countries. Most affected people reside in sub-Saharan Africa where Schistosoma mansoni, Schistosoma haematobium, and Schistosoma intercalatum are endemic. Schistosoma mansoni is endemic in parts of South America and the Caribbean. Schistosoma japonicum is endemic in China, the Philippines, and Indonesia.³ The life cycle involves skin penetration by cercariae that become schistosomula and migrate to the lung and then to the liver. . . . [Full Text of this Article]

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Arch Surg. 2007;142(5):487.
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