{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T17:12:41Z","timestamp":1755796361434,"version":"3.44.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>To characterize <jats:italic>Campylobacter<\/jats:italic> enteritis presenting as pseudo-appendicitis and identify distinguishing predicting factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective multicentre study included all children &amp;lt;18 years with confirmed <jats:italic>Campylobacter<\/jats:italic> infection, hospitalized from 2014 to 2023 for presumed appendicitis (pseudo-appendicitis group). Each case was matched with 2 controls with confirmed appendicitis. Multivariable logistic regression analysis was conducted to determine the potential predictors for pseudo-appendicitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty-five cases of pseudo-appendicitis were compared with 110 cases of appendicitis. The rate of peritoneal signs was similar between the two groups (78.2% vs. 75.5%, <jats:italic>P<\/jats:italic>\u2009=\u20090.07). Computed-tomography (CT) scans were performed nearly twice as often in the pseudo-appendicitis group (38% vs. 20%, <jats:italic>P<\/jats:italic>\u2009=\u20090.01). Broad-spectrum antibiotics were administered to 19 (34.5%) of patients with pseudo-appendicitis and none had surgery. Independent predictors of pseudo-appendicitis included: history of fever (OR: 17.2, 95% CI: 4.7\u201362.9, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.01), WBC &amp;lt;12,000\/<jats:italic>\u03bc<\/jats:italic>l (OR: 9.6, 95% CI: 2.9\u201331, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.01), sonographic signs of enlarged mesenteric lymphadenopathy and\/or ileocolitis (OR:5.8, 95% CI:1.8\u201318.6, <jats:italic>P<\/jats:italic>\u2009=\u20090.03), no sonographic sign of appendicitis (OR: \u22125.8, 95% CI: 1.3\u201325, <jats:italic>P<\/jats:italic>\u2009=\u20090.02), diarrhea (OR: 3.7, 95% CI:1.2\u201311.3, <jats:italic>P<\/jats:italic>\u2009=\u20090.02), and age &amp;gt;14 years (OR:3.3, 95% CI:0.91\u201312, <jats:italic>P<\/jats:italic>\u2009=\u20090.06).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The diagnostic challenge of <jats:italic>Campylobacter<\/jats:italic> pseudo-appendicitis notably led to high rates of CT imaging and unnecessary broad-spectrum antibiotic administration. We identified predictors that may prompt clinicians to consider <jats:italic>Campylobacter<\/jats:italic> enteritis in selected cases of suspected appendicitis, potentially encouraging early molecular diagnosis and improving patient care.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2025.1583429","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T04:10:26Z","timestamp":1755490226000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Campylobacter infection presenting as pseudo-appendicitis in children: identifying predictors for early diagnosis"],"prefix":"10.3389","volume":"13","author":[{"given":"Michael","family":"Schnapper","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaara","family":"Kahan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amir","family":"Klivitsky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Guri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Shatzman Steuerman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maya","family":"Heled Akiva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Tasher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"S103","DOI":"10.1086\/513780","article-title":"Epidemiologic and clinical features of Campylobacter jejuni infections","volume":"176","author":"Blaser","year":"1997","journal-title":"J Infect Dis"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e00205\u201319","DOI":"10.1128\/JCM.00205-19","article-title":"Comparative evaluation of enteric bacterial culture and a molecular multiplex syndromic panel in children with acute gastroenteritis","volume":"57","author":"Kellner","year":"2019","journal-title":"J Clin Microbiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1016\/S0140-6736(89)90322-X","article-title":"Incidence and sonographic diagnosis of bacterial ileocaecitis masquerading as appendicitis","volume":"2","author":"Puylaert","year":"1989","journal-title":"Lancet"},{"key":"B4","doi-asserted-by":"publisher","first-page":"bcr2013202198","DOI":"10.1136\/bcr-2013-202198","article-title":"Enterocolitis without diarrhoea in an adult patient: a clinical dilemma","volume":"2014","author":"Vaidya","year":"2014","journal-title":"BMJ Case Rep"},{"key":"B5","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1007\/s10096-008-0562-y","article-title":"Yersinia enterocolitica infection in diarrheal patients","volume":"27","author":"Zheng","year":"2008","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"B6","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1111\/j.1699-0463.1967.tb05182.x","article-title":"Studies on Yersinia enterocolitica. 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