Histopathology (appendix):
Findings: Acute on chronic granulomatous appendicitis; with multiple granulomata, most non-necrotizing, but with a few showing necrosis.
Comment: The differential diagnoses include tuberculosis, atypical mycobacterial infection, Yersinia infection and Crohn disease. In the clinical context, infection, particularly with tuberculosis, is considered far more likely than Crohn disease.