title: Escherichia coli septicemia in nonperforated appendicitis.
abstract: OBJECTIVE
  To determine the association between nonperforated appendicitis and Escherichia coli septicemia, and the frequency with which blood cultures are obtained in the clinical setting of appendicitis.
  
  
  METHODS
  Three case reports of E coli septicemia and nonperforated appendicitis and a retrospective survey.
  
  
  METHODS
  Children's Medical Center, Dallas, Tex, a primary care and tertiary referral center.
  
  
  METHODS
  All children admitted in a 2-year period with a diagnosis of appendicitis.
  
  
  METHODS
  None.
  
  
  RESULTS
  Preoperative blood cultures were obtained in 20 (21%) of 96 patients with histologic evidence of appendicitis. Fifty percent of the patients had gross or microscopic evidence of appendiceal perforation. Twelve (25%) of the 48 patients with perforated appendicitis had blood cultures obtained before the initiation of antimicrobial therapy, and in two of these patients (17%) the results were positive. Blood cultures were drawn before antibiotic therapy in four (8%) of the 48 patients with nonperforated appendicitis, and in two of these the results were positive. The blood culture isolates (coagulase-negative Staphylococcus and E coli) were the same in both groups.
  
  
  CONCLUSIONS
  Nonperforated appendicitis and septicemia may be more common than formerly appreciated. Only a prospective study can determine the true incidence of septicemia in children with perforated or nonperforated appendicitis.
authors.affiliation: Department of Pediatrics, Ireland Army Hospital, Ft Knox, Ky.
authors.forename: M E
authors.initials: ME
authors.lastname: Ruff
authors.forename: I R
authors.initials: IR
authors.lastname: Friedland
authors.forename: S M
authors.initials: SM
authors.lastname: Hickey
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001062:Appendectomy; D001064:Appendicitis / Q000453:epidemiology* / Q000382:microbiology* / Q000628:therapy; D016470:Bacteremia / Q000097:blood / Q000150:complications*; D002648:Child; D003131:Combined Modality Therapy; D004927:Escherichia coli Infections / Q000097:blood / Q000150:complications*; D006801:Humans; D015994:Incidence; D008297:Male; D011300:Preoperative Care; D012189:Retrospective Studies; D012422:Rupture, Spontaneous
chemical_list: D000900:Anti-Bacterial Agents