{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T03:00:31Z","timestamp":1784775631752,"version":"3.55.0"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:p>Although <jats:italic toggle=\"yes\">Blastocystis<\/jats:italic> sp. has been classically considered a commensal parasite with limited pathogenicity, recent studies suggest that its pathogenic potential is high. We report the case of a 9-year-old Spanish male who presented with peritonitis secondary to acute appendicitis with abundant intra-abdominal turbid-free fluid. A standard appendectomy was performed, and a sample of the fluid was taken for microbiological culture. Multimicrobial flora was isolated in peritoneal fluid culture. The antibiotic resistance study showed that all the microorganisms were sensitive to meropenem. On the 5th postoperative day, a control blood test showed relative eosinophilia and a persistently elevated C-reactive protein. A stool parasitological study showed abundant cysts morphologically compatible with <jats:italic toggle=\"yes\">Blastocystis hominis<\/jats:italic>. The hematoxylin &amp; eosin and Giemsa study identified abundant parasitic cysts in the appendix. The patient evolved favorably and is currently asymptomatic and under follow-up. Regarding acute appendicitis, there is only one report in the literature of peritonitis of appendiceal origin associated with <jats:italic toggle=\"yes\">Blastocystis<\/jats:italic> sp. In conclusion, although infrequent, parasitosis should be considered as a potential etiological agent of acute appendicitis, even in nonendemic areas. Relative eosinophilia or persistently elevated acute phase reactants despite adequate antibiotic coverage should help to establish diagnostic suspicion.<\/jats:p>","DOI":"10.1097\/inf.0000000000004396","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T20:01:57Z","timestamp":1715889717000},"page":"e327-e330","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Blastocystis hominis-associated Acute Appendicular Peritonitis in a 9-Year-old Boy: A Case Report and a Comprehensive Review of the Literature"],"prefix":"10.1097","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0943-6367","authenticated-orcid":false,"given":"Javier","family":"Arredondo Montero","sequence":"first","affiliation":[{"name":"From the Pediatric Surgery Department"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"S\u00e1ez \u00c1lvarez","sequence":"additional","affiliation":[{"name":"Pathology Department, Complejo Asistencial Universitario de Le\u00f3n, Le\u00f3n"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f3nica","family":"Bronte Anaut","sequence":"additional","affiliation":[{"name":"Pathology Department, Hospital General R\u00edo Carri\u00f3n, Palencia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramiro","family":"L\u00f3pez Medrano","sequence":"additional","affiliation":[{"name":"Microbiology & Parasitology Department, Complejo Asistencial Universitario de Le\u00f3n, Le\u00f3n, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Antonia","family":"Remacha Esteras","sequence":"additional","affiliation":[{"name":"Microbiology & Parasitology Department, Complejo Asistencial Universitario de Le\u00f3n, Le\u00f3n, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Rodr\u00edguez Ruiz","sequence":"additional","affiliation":[{"name":"From the Pediatric Surgery Department"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Miguel","family":"Izquierdo Garc\u00eda","sequence":"additional","affiliation":[{"name":"Pathology Department, Complejo Asistencial Universitario de Le\u00f3n, Le\u00f3n"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,5,10]]},"reference":[{"key":"R1-20250614","doi-asserted-by":"crossref","first-page":"461","DOI":"10.3390\/microorganisms12030461","article-title":"Blastocystis: a mysterious member of the gut microbiome.","volume":"12","author":"Aykur","year":"2024","journal-title":"Microorganisms"},{"key":"R2-20250614","first-page":"90","article-title":"The prevalence of Blastocystis sp. and its relationship with gastrointestinal disorders and risk factors.","volume":"17","author":"Viesy","year":"2022","journal-title":"Iran J Parasitol"},{"key":"R3-20250614","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1051\/parasite\/2024012","article-title":"Molecular prevalence and subtype distribution of Blastocystis sp. among children who have diarrhea or are asymptomatic in Wenzhou, Zhejiang Province, China.","volume":"31","author":"Zhao","year":"2024","journal-title":"Parasite"},{"key":"R4-20250614","doi-asserted-by":"crossref","first-page":"224","DOI":"10.4274\/tpd.galenos.2023.93585","article-title":"Spread of intestinal parasites in patients presenting with gastrointestinal complaints.","volume":"47","author":"Ekici","year":"2023","journal-title":"Turkiye Parazitol Derg"},{"key":"R5-20250614","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.3390\/pathogens12081050","article-title":"Epidemiology of Blastocystis infection: a review of data from Poland concerning other reports.","volume":"12","author":"Rudzi\u0144ska","year":"2023","journal-title":"Pathogens"},{"key":"R6-20250614","doi-asserted-by":"crossref","first-page":"226","DOI":"10.3390\/tropicalmed7090226","article-title":"Prevalence and associated factors of Blastocystis sp. infection in patients with gastrointestinal symptoms in Spain: a case-control study.","volume":"7","author":"Matovelle","year":"2022","journal-title":"Trop Med Infect Dis"},{"key":"R7-20250614","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/s00431-022-04662-x","article-title":"Prevalence and temporal dynamics of Cryptosporidium spp., Giardia duodenalis, and Blastocystis sp. among toddlers attending day-care centres in Spain. A prospective molecular-based longitudinal study.","volume":"182","author":"Hern\u00e1ndez-Castro","year":"2023","journal-title":"Eur J Pediatr"},{"key":"R8-20250614","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1186\/s13071-016-1827-4","article-title":"Epidemiological and clinical profile of adult patients with Blastocystis sp. infection in Barcelona, Spain.","volume":"9","author":"Salvador","year":"2016","journal-title":"Parasit Vectors"},{"key":"R9-20250614","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00436-022-07731-0","article-title":"Blastocystis occurrence in water sources worldwide from 2005 to 2022: a review.","volume":"122","author":"Attah","year":"2023","journal-title":"Parasitol Res"},{"key":"R10-20250614","doi-asserted-by":"crossref","first-page":"191","DOI":"10.3390\/vetsci8090191","article-title":"Molecular detection and characterization of Blastocystis sp. and Enterocytozoon bieneusi in cattle in Northern Spain.","volume":"8","author":"Abarca","year":"2021","journal-title":"Vet Sci"},{"key":"R11-20250614","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1111\/jeu.12772","article-title":"Blastocystis sp. subtype diversity in wild carnivore species from Spain.","volume":"67","author":"Calero-Bernal","year":"2020","journal-title":"J Eukaryot Microbiol"},{"key":"R12-20250614","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1159\/000325628","article-title":"Cytologic diagnosis of Blastocystis hominis in peritoneal fluid: a case report.","volume":"52","author":"Patino","year":"2008","journal-title":"Acta Cytol"},{"key":"R13-20250614","doi-asserted-by":"crossref","first-page":"91","DOI":"10.3201\/eid2101.140544","article-title":"Acute Blastocystis-associated appendicular peritonitis in a child, Casablanca, Morocco.","volume":"21","author":"Fr\u00e9alle","year":"2015","journal-title":"Emerg Infect Dis"}],"container-title":["Pediatric Infectious Disease Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/INF.0000000000004396","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T23:06:37Z","timestamp":1749942397000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/INF.0000000000004396"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,10]]},"references-count":13,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1097\/inf.0000000000004396","relation":{},"ISSN":["0891-3668","1532-0987"],"issn-type":[{"value":"0891-3668","type":"print"},{"value":"1532-0987","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,10]]}}}