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[Spontaneous bacterial peritonitis without ascites]
Summary
A rare case of sepsis caused by group A streptococci led to peritonitis in a woman with prior hepatitis. This spontaneous bacterial peritonitis occurred without ascites, highlighting a unique infectious presentation.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Surgical Pathology
Background:
- A 34-year-old woman with a history of non-A-non-B hepatitis presented with acute lower abdominal pain.
- Initial laparotomy revealed diffuse redness of the small bowel but no ascites or clear source of infection.
Observation:
- The patient developed sepsis within 60 hours post-appendectomy.
- Relaparotomy confirmed acute diffuse peritonitis with ascites, yet no intra-abdominal source was identified.
Findings:
- Cultures from tracheal, blood, and peritoneal samples grew group A streptococci.
- This indicated a hematogenous spread of infection, leading to spontaneous bacterial peritonitis.
Implications:
- The case presents a rare instance of spontaneous bacterial peritonitis without ascites.
- Successful treatment involved antibiotics and peritoneal lavage, underscoring the importance of identifying hematogenous spread in peritonitis.