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Background: Multi-drug-resistant bacteria are rarely isolated from patients with acute appendicitis.

Methods: Case report and literature review.

Results: We report an unusual case of post-appendectomy intra-abdominal abscess with intra- operative cultures that grew multi-drug-resistant Acinetobacter baumannii. An 11–year-old boy underwent open appendectomy for perforated appendicitis. He developed a superficial surgical site infection at the Penrose drain site on the seventh postoperative day; cultures grew multi-drug-resistant Acinetobacter baumannii. A computed tomography scan revealed an intra- abdominal abscess. Open drainage was performed, and intra-operative cultures grew the same multi-drug-resistant A. baumannii along with Escherichia coli.

Conclusions: Post-operative therapy with ceftriaxone may have predisposed the patient to nosocomial infection caused by multi-drug-resistant A. baumannii.