Ana Cardoso , David Jolley , Ann Regan , Michael Tapley .

Sir, The recent report on ‘Acute appendicitis and Schistosomiasis’ is very interesting.1 Figueiredo et al noted for ‘possibility of finding more patients with concurrent appendicitis and schistosomiasis’.1 In fact, the parasitic acute appendicitis is not an uncommon problem in the tropical world. According to the recent report by Jada et al, it was reported that ‘among 100 specimens, 48 faecolith analysis proved to be positive for parasitic association, giving 48% positivity, which is quite high’.2 In the present day, due to the globalization, the trend of rising parasitic acute appendicitis in the Western countries can also be observed.3 There are many issues to be addressed for this specific disease. Although it is relating to parasitic infestation, the classical stool examination usually reveals no parasite in the case.2 The careful examination on the surgical specimen and faecolith is needed for diagnosis. The diagnosis can also imply for the necessity for management of detected parasitic infestation in the patient.