Appendicitis in a Patient with an Adenovirus Infection

 

When to suspect adenovirus-associated appendicitis:

(1) one or more of the following:

(1a) presence of mesenteric adenitis

(1b) presence of ileocecal intussusception

(1c) marked lymphoid hyperplasia without acute appendicitis

(2) There is an outbreak of adenovirus in the community.

(3) The patient has signs and symptoms of an adenovirus infection.

 

If adenovirus is suspected then epithelial cells in the appendiceal mucosa should be examined for signs of viral infection:

(1) eosinophilic intranuclear inclusions

(2) smudge cells

 

If suspicious cells are identified then immunoperoxidase stains can be performed to confirm the diagnosis.