Amoebic Appendicitis: A Rare Parasitic Cause of a Common Surgical Emergency

Abstract

Appendicitis is a common surgical emergency characterized by inflammation of the appendix, often attributed to luminal obstruction or bacterial infection. However, rare etiologies, such as parasitic infections, can also lead to appendicitis. Among these, Entamoeba histolytica, a protozoan parasite causing amoebiasis, is an infrequent but noteworthy cause. Amoebic infection of the appendix occurs when trophozoites invade the mucosal layer of the appendix, leading to inflammation, tissue necrosis, and, in severe disease, perforation. Amoebic appendicitis is more common in regions where amoebiasis is endemic, such as tropical and subtropical areas, and is often associated with poor sanitation and contaminated water supplies. The clinical presentation of amoebic appendicitis often mimics acute bacterial appendicitis, including abdominal pain, fever, and leukocytosis, making it challenging to diagnose preoperatively. The condition may coexist with colonic amoebiasis or present independently. The severity of amoebic appendicitis may be much more than that of bacterial appendicitis, and it may require more intensive management, hence the importance of knowing the diagnosis. Histopathological examination and identification of E histolytica in the appendix are crucial for a definitive diagnosis. Prompt surgical intervention, along with anti-amoebic therapy, is essential for successful management. This case report highlights an uncommon etiology of appendicitis due to amoebic infection, emphasizing the need for clinicians to consider parasitic etiologies in regions where amoebiasis is prevalent.