{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:34:13Z","timestamp":1789778053008,"version":"4.0.1"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2023,4,22]],"date-time":"2023-04-22T00:00:00Z","timestamp":1682121600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>This study aimed to explore the clinical characteristics of septic shock in pediatric patients caused by acute appendicitis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This case series included patients with septic shock caused by acute appendicitis in Beijing Children's Hospital between January 2015 and December 2020.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Six patients with septic shock caused by acute appendicitis were enrolled. One patient was an infant with extremely low weight; 2 patients were obese. The diagnosis was delayed in 4 patients (the time from onset to diagnosis was 5 days in 3 children and 4 days in 1 child). All patients had abnormally raised inflammatory markers (C-reactive protein 119.17 \u00b1 48.36 mg\/L, procalcitonin 129.95 \u00b1 86.09 ng\/mL). Severe abdominal infection was found in all patients. There was appendix perforation in 4 patients and diffused peritonitis in 3 patients. Two patients had metabolic diseases (Wilson disease and decreased biotinase activity, respectively). Five patients had an appendectomy and 1 patient received conservative treatment. Five patients were discharged in stable condition, while 1 patient died.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Children with delayed diagnosis, abnormal body weight, significant elevation in inflammatory markers, and underlying metabolic disease may be at greater risk of complicated appendicitis and septic shock.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Evidence-Based Medicine<\/jats:title>\n            <jats:p>Level of Evidence: IV<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000002946","type":"journal-article","created":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T18:09:29Z","timestamp":1682100569000},"page":"511-515","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Clinical Characteristics of Pediatric Patients With Septic Shock Caused by Acute Appendicitis"],"prefix":"10.1097","volume":"39","author":[{"given":"Fangnan","family":"Xie","sequence":"first","affiliation":[{"name":"Emergency Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Wang","sequence":"additional","affiliation":[{"name":"Emergency Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Chen","sequence":"additional","affiliation":[{"name":"Emergency Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuanling","family":"Li","sequence":"additional","affiliation":[{"name":"Emergency Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiulong","family":"Shen","sequence":"additional","affiliation":[{"name":"Emergency Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianling","family":"Li","sequence":"additional","affiliation":[{"name":"Emergency Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Liu","sequence":"additional","affiliation":[{"name":"Emergency Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongwei","family":"Chen","sequence":"additional","affiliation":[{"name":"Neonatal Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dayong","family":"Wang","sequence":"additional","affiliation":[{"name":"Emergency Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,4,22]]},"reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1097\/01.PCC.0000149131.72248.E6","article-title":"International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in 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acute appendicitis complicated with abscess formation within mesoappendix: a case report","volume":"76","year":"2020","journal-title":"Int J Surg Case Rep"},{"key":"bib14-20250504","doi-asserted-by":"crossref","first-page":"bcr2014209275","DOI":"10.1136\/bcr-2014-209275","article-title":"Biotinidase deficiency mimicking primary immune deficiencies","volume":"2015","year":"2015","journal-title":"BMJ Case Rep"},{"key":"bib15-20250504","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1053\/j.semdp.2019.07.008","article-title":"Wilson disease","volume":"36","year":"2019","journal-title":"Semin Diagn Pathol"}],"container-title":["Pediatric Emergency 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