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Peritonitis in children with nephrotic syndrome
M J Gorensek1, M H Lebel, J D Nelson
1Department of Pediatrics, University of Texas Health Science Center, Dallas.
Pediatrics
|June 1, 1988
Summary
Primary peritonitis in children with nephrotic syndrome is often caused by Streptococcus pneumoniae. Penicillin is effective, but combination therapy may be needed initially for suspected cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Nephrology
Background:
- Nephrotic syndrome increases children's risk of peritonitis.
- Understanding the causative agents and treatment outcomes is crucial for managing this complication.
Purpose of the Study:
- To analyze the incidence, bacteriology, and clinical features of primary peritonitis in children with nephrotic syndrome.
- To evaluate the effectiveness of antimicrobial therapy.
Main Methods:
- Retrospective review of 214 children with nephrotic syndrome over a 20-year period (1967-1986).
- Identification and analysis of 62 cases of primary peritonitis.
- Review of clinical presentation, causative pathogens, and treatment responses.
Main Results:
- Primary peritonitis occurred in 17.3% of patients.
- Streptococcus pneumoniae was the most common pathogen (38%).
- Gram-negative organisms were infrequent (3%); findings contrast with recent literature trends.
Conclusions:
- The incidence and bacteriology of peritonitis in nephrotic children remained stable over the study period.
- Initial treatment with penicillin plus an aminoglycoside or cephalosporin is recommended for suspected peritonitis.
- Penicillin monotherapy is sufficient if Gram-positive diplococci are identified.