[Pneumococcal peritonitis--why women?]

Pneumococcal peritonitis is rare in adults without cirrhosis, ascites or nephrotic syndrome. Women comprise the majority of patients: an ascending genital infection is thought to be the major portal of entry. This is a case study of severe pneumococcal peritonitis in a young woman with no predisposing features. During laparoscopic laparotomy, abundant pus was found in the peritoneal cavity. Cultures grew Streptococcus pneumoniae. The post-operative course was complicated by acute respiratory distress. Dyspnea, elevated body temperature and elevated inflammatory markers, continued for more than two weeks, despite appropriate antibiotic therapy. We traced two additional cases of pneumococcal peritonitis at our hospital during the last decade. Pneumococci should be considered in the differential diagnosis of any young woman who develops peritonitis without an obvious cause.