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JAMA Revisited
June 16, 2015

Appendicitis and Infectious Diseases

JAMA. 2015;313(23):2384. doi:10.1001/jama.2014.11828

The pre-eminently local character of appendicitis and its successful surgical treatment have undoubtedly served to distract the attention from its possible relations to infectious diseases in general. In the large majority of the cases local conditions appear to explain satisfactorily the development of appendicitis and its consequences, but there are also forms of appendicitis in which the etiology is not quite so simple, and it is to these forms that Finney and Hamburger1 direct attention. “Propagated appendicitis” is the term applied by M. Reclus to appendicitis developing from extension of enterocolitis. The nature of the appendix favors stagnation and increased bacterial virulence, which result in greater intensity of the resulting lesions of this part of the intestine. Then there are cases in which appendicitis seems to be a “local expression of a general infection.” Finney and Hamburger cite three cases associated with rheumatic polyarthritis, and they also refer to similar observations by previous writers not only in the case of rheumatic polyarthritis but also in other infectious diseases, such as measles, typhoid fever, scarlet fever, influenza, etc.

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