Concurrent COVID-19 Infection in Children with Acute Appendicitis: A Report of Three Cases

Authors

Maximo J. Acevedo, University of KentuckyFollow
Dylan Steffey, University of Kentucky
Johanne E. Dillon, University of KentuckyFollow
James T. Lee, University of KentuckyFollow
David J. Worhunsky, University of KentuckyFollow

Abstract

Literature describing patients with concomitant COVID-19 infection with acute appendicitis in pediatric patients is growing, and understanding the clinical picture of such patients is relevant in their treatment. We report 3 male children who were surgically treated for acute appendicitis and had concomitant SARS-CoV-2 infection. Our first patient was a 12-year-old male who presented with symptoms indicative of appendicitis but no respiratory symptoms associated with COVID-19 (eg cough, shortness of breath). Laboratory evaluation revealed leukopenia and an elevated C-reactive protein; imaging was consistent with acute appendicitis and an acute pulmonary viral infection. Though he lacked diffuse peritonitis on physical examination or a leukocytosis, he was found to have perforated appendicitis in the operating room. Our second patient was another 12-year-old male whose suspected appendicitis was confirmed via ultrasound and surgery. He tested positive for COVID-19 1 month prior and he continued to test positive for infection on admission without any associated respiratory symptoms. Our third patient was a 13-year-old patient who also presented with symptomatic acute appendicitis without apparent COVID-19 manifestations. These cases provide further examples of pediatric patients with concomitant acute appendicitis and COVID-19 infection, namely an unusual presentation of perforated appendicitis with asymptomatic COVID-19-related pulmonary infection and the more common acute appendicitis with asymptomatic COVID-19 infection.

Document Type

Article

Publication Date

6-28-2021

Notes/Citation Information

Published in Radiology Case Reports, v. 16, issue 10.

© 2021 The Authors

This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Digital Object Identifier (DOI)

https://doi.org/10.1016/j.radcr.2021.06.067

Repository Citation

Acevedo, Maximo J.; Steffey, Dylan; Dillon, Johanne E.; Lee, James T.; and Worhunsky, David J., "Concurrent COVID-19 Infection in Children with Acute Appendicitis: A Report of Three Cases" (2021). Radiology Faculty Publications. 35.
https://uknowledge.uky.edu/radiology_facpub/35