Leukemoid reaction in a child with appendiceal abscess: a case report.
A case of appendiceal abscess presenting leukemoid reaction is reported. A seven-month-old male infant was admitted because of fever and diarrhea. Anemic conjunctiva and mild abdominal distension were the only physical findings on arrival. Progressive leukocytosis with left shift maturation was noted during hospitalization. The maximal white blood cell count was 178,000/cumm, with a high leukocyte alkaline phosphatase score. On the fourth day of admission, a palpable right lower quadrant abdominal mass with local tenderness was found. Appendiceal abscess was diagnosed by both ultrasonography and computed tomography. The infant received triple antibiotic therapy consisting of ampicillin, gentamicin, and clindamycin for 10 days; the mass disappeared two weeks later. As appendiceal abscess is a rare occurrence in infants and its production of a leukemoid reaction is even rarer, the case described here may cause a diagnostic challenge, and deserves attention from clinicians.
Department of Pediatrics, Taichung Veterans General Hospital, Taiwan, R.O.C.
Y J
YJ
Wang
W J
WJ
Shian
H Y
HY
Chu
C S
CS
Chi
D000038:Abscess / Q000150:complications*; D001064:Appendicitis / Q000150:complications*; D003937:Diagnosis, Differential; D006801:Humans; D007223:Infant; D007955:Leukemoid Reaction / Q000175:diagnosis / Q000209:etiology*; D008297:Male