Acute Perforated Appendicitis Due to <i>Shigella flexneri</i>; A Rare Case Report

Introduction: This case report presents a rare manifestation of Shigella infection: Acute perforated appendicitis. It emphasizes the importance of differential diagnosis in patients presenting with diarrhea, especially when symptoms overlap with surgical emergencies like appendicitis. Case Presentation: Our case involved a 10-year-old girl who was referred to our hospital with complaints of abdominal pain and non-bloody watery diarrhea. Clinical examinations confirmed acute appendicitis, and an appendectomy was performed. A few days post-surgery, the patient developed dysentery. Stool culture identified Shigella flexneri, and the patient was treated with Piperacillin/tazobactam and ciprofloxacin based on the antibiogram and consultation with the infectious disease team. The patient responded well to treatment and was discharged in good general condition after completing the full course of therapy. Conclusions: Although shigellosis is a common gastrointestinal infection, it is rarely linked to appendicitis. This case highlights the need for thorough evaluation in patients with diarrhea, as infectious conditions like shigellosis can mimic or coexist with acute appendicitis, leading to potential diagnostic and management challenges.