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March 9, 1984

Appendicitis Manifested as Lumbar Plexus Neuritis

Author Affiliations

University of California, Davis Veterans Administration Medical Center Martinez, Calif

JAMA. 1984;251(10):1280. doi:10.1001/jama.1984.03340340022016

To the Editor.—  Appendicitis commonly afflicts 7% of the population. With classic symptoms, it poses no diagnostic puzzle. However, since a delay in appropriate treatment produces substantial mortality, internists have been cautioned to be aware of highly atypical manifestations of appendicitis.1-4 We report a case of appendicitis manifested as a lumbar plexus neuritis.

Report of a Case.—  A 72-year-old man was admitted to the hospital with complaints of pain and weakness of the right lower extremity. Four days before admission, he awoke at midnight with burning pain over his right anterior and medial thigh, which recurred intermittently over the next four days. He had no fevers, chills, anorexia, nausea, vomiting, change in bowel habits, dysuria, or abdominal pain.On admission, he was afebrile. His abdominal examination results were unremarkable. There was a notable weakness of the right iliopsoas muscle and mild right quadriceps muscle weakness. There was a patchy