Frequency of portal and systemic bacteremia in acute appendicitis

Background: Acute appendicitis is the most common condition requiring an em ergency abdominal operation in childhood. In the present study, we analyzed the frequency of portal and systemic bacteremia in 42 patients with acute appendicitis and determined the microbial agents: responsible for an acute appendicitis and for portal and systemic bacteremia. Methods: Appendectomies were performed on 50 young patients (5-18 years of age), as well as clinical and bacteriological tests. Six independent sample s from each patient isolated from the peripheral vein, superior mesenteric vein, appendix and peritoneum were obtained prior to surgery, during surger y and after surgery for biochemical, immunologic and bacteriologic examinat ion. Results: Pathohistology confirmed the diagnosis of appendicitis in 42 patie nts, while in the other eight patients there were no obvious pathologic fin dings, so they served as a control group. Of 50 patients with a clinical ap pearance of acute appendicitis, in 19 patients (38%) we detected portal bac teremia in the mesenteric vein, while in only three cases (6%) did we find systemic bacteremia detected from the peripheral vein. Furthermore, bacteri ologic analysis revealed that Bacteroides spp and Escherichia coli were the predominant species isolated. Conclusions: The results presented in this paper suggests that portal bacte remia did not influence peripheral blood reactions. Furthermore, in the pre sent study we have found a positive correlation between the smear and bacte remia of the superior mesenteric vein, but not with the bacteremia of syste mic blood.