title: Appendicular tuberculosis: the resurgence of an old disease with difficult diagnosis.
abstract: Gastrointestinal tuberculosis (TB) is quite rare, representing only 3% of all extra-pulmonary cases. Blind gut and ileum are the most common gastrointestinal localizations, while appendix involvement is infrequent. Appendix involvement is usually related to symptoms of acute appendicitis since the caseous necrosis may lead to adhesions and surgical complications such as perforation. For this reason patients with suspected appendicular TB usually undergo surgery even without a secure diagnosis. In these cases, due to the absence of specific symptoms and signs, the diagnosis is delayed after surgery, thus resulting in a high percentage of important, and sometimes lethal, complications. Histopathological examination is often the only way to reach a diagnosis and to establish specific antibiotic therapy, while an early diagnosis could avoid surgical treatment. We report a case of appendicular TB not only for its rarity but also to discuss the difficulty in its diagnosis.
authors.affiliation: Department of Surgical Sciences, Transplantation and New Technologies, University of Catania, Via Messina 354, 95126 Catania, Italy. barbaf74@tiscali.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Barbagallo
authors.forename: Saverio
authors.initials: S
authors.lastname: Latteri
authors.forename: Maria
authors.initials: M
authors.lastname: Sofia
authors.forename: Agostino
authors.initials: A
authors.lastname: Ricotta
authors.forename: Giorgio
authors.initials: G
authors.lastname: Castello
authors.forename: Andrea
authors.initials: A
authors.lastname: Chisari
authors.forename: Valentina
authors.initials: V
authors.lastname: Randazzo
authors.forename: Gaetano
authors.initials: G
authors.lastname: La Greca
mesh_terms: D000328:Adult; D001064:Appendicitis / Q000175:diagnosis*; D006801:Humans; D008297:Male; D014385:Tuberculosis, Gastrointestinal / Q000175:diagnosis*