1997 Volume 58 Issue 10 Pages 2381-2385
We experienced an emergency operation for a case of acute appendicitis with human immunodeficiency virus (HIV) infection. This paper reports on our strategy for dealing with the patient and the perioperative changes in inflammatory reaction. A 28-year-old man, who was pointed out hemophilia B at the age two and HIV infection at the age 18, had a right lower abdominal pain on February 12, and high grade fever on February 16, 1996. He was diagnosed as acute appendicitis at another hospital and was referred to our center because of HIV infection. On admission, white blood cell count was 3000/mm3 (2600/mm3 in October, 1995) and the level of CRP was 4.9mg/dl. At laparotomy, the vermiform appendix was swollen and covered with omentum, but adhesion was not prominent. Ascitis and the contents of vermiform appendix was old bloody fluid, and no pus was detected. Pathological study showed that the inflammation was phregmonous or gangrenous and nonspecific. High grade fever continued for 3 days after the operation. White blood cell count was 7700/mm3 at just after the operation and decreased to 1500/mm3 at the 5th postoperative day, and such change was thought to be due to natural course in HIV infection. The level of CRP increased after the operation to 7.6mg/dl on the 2nd post-operative day and decreased to 0.6mg/dl onthe 5th postoperative day. There was no delay of wound healing.
