{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T21:54:19Z","timestamp":1740174859034,"version":"3.37.3"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T00:00:00Z","timestamp":1668643200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T00:00:00Z","timestamp":1668643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Acute appendicitis is a common abdominal pathology, particularly in younger patients presenting with abdominal pain. The clinical presentation is typically characterized by right lower quadrant pain (with local peritonitis) accompanied by fever and nausea. In neutropenic patients it is challenging to diagnose acute appendicitis. It is much more challenging because the characteristic symptoms are different, and diagnosis may be delayed or missed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We present the case of a 33-year-old Caucasian male patient with fever, abdominal pain, and an absolute granulocyte count of 0\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L. Abdominal CT demonstrated an uncomplicated acute appendicitis. We initiated a conservative in-hospital treatment with intravenous antibiotic therapy and simultaneous bone marrow stimulation, with close monitoring. On day three, there was evidence of monocyte increase, one of the first signs of bone marrow regeneration, and delayed laparoscopic appendectomy was performed. The perioperative and postoperative course was uneventful.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>We discuss the different treatment strategies in patients with neutropenia presenting with acute appendicitis (i.e., conservative management, delayed appendectomy, and immediate appendectomy) based on our experience and a review of the literature. In summary, delayed laparoscopic appendectomy at the onset of granulocyte regeneration under antibiotic and G-CSF therapy represents a viable surgical option for adults as well as for children and should be discussed compared with conservative therapy.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40792-022-01563-x","type":"journal-article","created":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T13:03:44Z","timestamp":1668690224000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical approach for appendicitis in neutropenia: a case report and review of the literature"],"prefix":"10.1186","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8268-1190","authenticated-orcid":false,"given":"Ushanthan","family":"Uthayanan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter","family":"Kolb","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Schmied","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Bischofberger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,11,17]]},"reference":[{"key":"1563_CR1","doi-asserted-by":"publisher","first-page":"3258","DOI":"10.1007\/s11605-021-05116-9","volume":"25","author":"MG White","year":"2021","unstructured":"White MG, Morgan RB, Drazer MW, Eng OS. Gastrointestinal surgical emergencies in the neutropenic immunocompromised patient. J Gastrointest Surg. 2021;25:3258\u201364. https:\/\/doi.org\/10.1007\/s11605-021-05116-9.","journal-title":"J Gastrointest Surg"},{"key":"1563_CR2","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s13017-020-00306-3","volume":"15","author":"S Di Saverio","year":"2020","unstructured":"Di Saverio S, Podda M, de Simone B, Ceresoli M, Augustin G, Gori A, et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World J Emerg Surg. 2020;15:27. https:\/\/doi.org\/10.1186\/s13017-020-00306-3.","journal-title":"World J Emerg Surg"},{"key":"1563_CR3","doi-asserted-by":"publisher","first-page":"4668","DOI":"10.1007\/s00464-016-5245-7","volume":"30","author":"RR Gorter","year":"2016","unstructured":"Gorter RR, Eker HH, Gorter-Stam MAW, Abis GSA, Acharya A, Ankersmit M, et al. Diagnosis and management of acute appendicitis. EAES consensus development conference 2015. Surg Endosc. 2016;30:4668\u201390. https:\/\/doi.org\/10.1007\/s00464-016-5245-7.","journal-title":"Surg Endosc."},{"key":"1563_CR4","doi-asserted-by":"publisher","unstructured":"Reimer J, Franke GH, Ross B, Gerken G, Heemann U. HIV-Infektion: CDC-Klassifikation und Lebensqualit\u00e4t. In: HIV-Infekt: Springer, Berlin, Heidelberg; 2000. p.\u00a0751\u2013756. doi:https:\/\/doi.org\/10.1007\/978-3-642-59683-4_133.","DOI":"10.1007\/978-3-642-59683-4_133"},{"key":"1563_CR5","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1186\/ar3477","volume":"13","author":"DS Pisetsky","year":"2011","unstructured":"Pisetsky DS. Pus: the Rodney Dangerfield of immunology. 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A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"208"}}