Sir.—We have recently treated two children with concurrent pneumonia and appendicitis. In both, respiratory symptoms were prominent, but concomitant signs and symptoms related to the gastrointestinal tract and in excess of the usual secondary effects of pneumonia led the pediatrician to seek surgical consultation.
Report of Cases.—Case 1.—A 12-year-old girl was admitted because of cough and fever of six days' duration. There then developed abdominal pain, localized in the right lower quadrant, and vomiting. She was treated with antibiotic medication during this period. Examination showed mild dehydration. Rectal temperature was 38.6 C (101.5 F). Decreased breath sounds, rales, wheezes, and diminished resonance were noted over the right side of the chest posteriorly. There was tenderness on the lower right side of the abdomen, with involuntary muscular spasm. White blood cell (WBC) count was 13,200/cu mm, with 85% neutrophils, 12% lymphocytes, and 3% monocytes. Roentgenographic evaluation of the