Streptococcus anginosus and postoperative intraabdominal fluid collections after appendectomy

In the recent article by Subramanian et al., the authors conclude that Streptococcus anginosus is associated with postoperative intraabdominal collections in appendicitis [1]. While this is an interesting observation, I do not believe the data as presented clearly support this conclusion. There is consensus that the most important determinant of a postoperative abscess or symptomatic fluid collection after appendictomy is presentation with perforation. In presenting the primary outcome, the authors never make a distinction between simple appendicitis and perforated appendicitis.