Clinical Significance of Fever and Leukocytosis in Diagnosis of Acute Appendicitis in Children Who Visit Emergency Department With Abdominal Pain

Abstract

Background: The use of fever in the diagnosis of appendicitis in pediatric patients is unproven. The purpose of this investigation was to determine the value of fever in the diagnosis of acute appendicitis in children presenting to the emergency department (ED) with acute abdominal pain. Methods: Medical records from January-December, 2009, were reviewed for children (age < 18 years) who presented to an ED of one medical center with abdominal pain. Data on initial body temperature, white blood cell count, left shift, and final diagnosis were analyzed. Results: Of 674 children, 119 had appendicitis. The prevalance of initial fever did not differ between those with and without appendicitis, but the prevalence of leukocytosis and left shift were higher in children diagnosed with appendicitis. Despite of stratification by age, leukocytosis, prevalence of fever was not differing. Conclusions: Fever does not help in diagnosing appendicitis in our patients. Leukocytosis and white cell left shifts are on the other hand more common in patients with appendicitis. More studies should follow to investigate their role in diagnosis of appendicitis in patients in emergency department. doi:10.4021/ijcp104e