A 15-year-old Boy with Right Lower Quadrant Abdominal Pain and Fever

Abstract

1. Hira Ahmed, DO† 2. Alicia Kodsi, MD† 3. Christina Gagliardo, MD*,‡ 4. Santina Bruno, DO† 5. Michelle Katzow, MD, MS† 1. *Division of Pediatric Infectious Diseases and 2. †Department of Pediatrics, Maimonides Infants and Children’s Hospital, Brooklyn, NY; 3. ‡Department of Pediatrics, Albert Einstein College of Medicine A 15-year-old previously healthy boy presents to the emergency department (ED) with 1 day of fever, right lower quadrant (RLQ) abdominal pain, and one episode of nonbloody, nonbilious emesis. A clinical diagnosis of acute appendicitis is made, and he undergoes laparoscopic appendectomy and is discharged on postoperative day 1 without any pain. A pathology evaluation of the removed tissue reveals a normal appendix. Two days after discharge, he develops right hip and thigh pain, which progresses over the next 4 days; he again presents to the ED. Physical examination is significant for fever of 40.3°C, RLQ tenderness without rebound or guarding, well-healing surgical …