A Retrospective Study of the Use of Biochemical Markers to Predict Enterobius vermicularis Infection in Paediatric Patients at the Time of Appendicectomy

TL;DR

This study explores using blood markers to predict a common parasitic infection in children presenting with appendicitis symptoms, potentially avoiding unnecessary surgery.

Contribution

The study identifies eosinophil count as a novel predictive biomarker for Enterobius vermicularis infection in pediatric patients.

Findings

Eosinophil count was a superior predictor of E. vermicularis infection compared to neutrophil count.

Eosinophil count showed a sensitivity of 76.67% and specificity of 59.91% in predicting E. vermicularis.

No significant differences in age, sex, or Modified Monash Model status were found between groups.

Abstract

Background: Symptomatology of acute appendicitis is a common presentation in children, and Enterobius vermicularis (E. vermicularis) is an often-overlooked aetiology. No studies have identified or explored the predictive performance of biomarkers for preoperative identification of E. vermicularis in paediatric patients. The aim of this study was to assess the utility of biochemical markers in predicting E. vermicularis and potentially preventing unnecessary appendicectomy.

Methods: This is a single-centre retrospective cohort study of paediatric patients ≤16 years who presented to Ipswich Hospital with symptomatology of acute appendicitis between January 2019 and January 2024. Five hundred and ninety-three patients were screened against inclusion and exclusion criteria, and 469 patients were available for analysis.

Results: There were no statistically significant differences in age, biological sex, or Modified Monash Model (MMM) status in the population examined. The study identified neutrophil count (OR 0.901, p = 0.032) and eosinophil count (OR 3.081, p = 0.013) as significant coefficients in predicting E. vermicularis on histopathology following logistic regression analysis. Eosinophil count was found to be a superior predictor of E. vermicularis following receiver operating characteristic (ROC) analysis (AUC 0.713, sensitivity 76.67%, specificity 59.91%, p < 0.001) compared with neutrophil count.

Conclusion: In this large study, we examined the demographics of children with E. vermicularis infestation presenting with symptomatology of acute appendicitis and validated the performance of biomarkers as predictive tools for E. vermicularis infestation. Eosinophil count is effective at predicting E vermicularis infection and may be valuable in preventing unnecessary appendicectomy.

Figures