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Primary peritonitis in previously healthy children
Insights
Primary peritonitis in children is rare but treatable. This study found seven healthy children diagnosed via laparotomy, with prompt recovery after antibiotic treatment, highlighting the importance of considering this diagnosis.
Area of Science:
- Pediatric Infectious Diseases
- Surgical Gastroenterology
Background:
- Primary peritonitis is uncommon in previously healthy children.
- Diagnosis can be challenging due to overlapping symptoms with acute appendicitis.
Purpose of the Study:
- To review clinical experience with primary peritonitis in children.
- To identify common etiologic agents and treatment outcomes.
Main Methods:
- Retrospective review of seven pediatric cases over 22 years.
- Diagnosis confirmed by laparotomy.
- Microbiologic cultures and clinical data analyzed.
Main Results:
- Symptoms included abdominal pain, fever, vomiting, and diarrhea.
- Five cases presented with right lower quadrant tenderness, mimicking appendicitis.
- Streptococcus pneumoniae and group A beta-hemolytic Streptococcus were identified pathogens.
Conclusions:
- Primary peritonitis in children, though rare, requires prompt diagnosis and antibiotic treatment.
- Early intervention leads to complete recovery without complications.
- Long-term follow-up indicates sustained health post-recovery.
Abstract:
In a review of 22 years of clinical experience, we found seven previously healthy children with primary peritonitis. The diagnosis was made at laparotomy in all patients. Their symptoms included diffuse abdominal pain, fever, vomiting, and diarrhea. Abdominal tenderness was maximal in the right lower quadrant in five children, which led to confusion with the diagnosis of acute appendicitis. Streptococcus pneumoniae was identified as the etiologic agent in three patients and group A beta-hemolytic Streptococcus in one patient. The remaining three patients all had prior antibiotic therapy, and peritoneal fluid cultures were sterile. All children had a prompt response to treatment with antibiotics and recovered without complications. Long-term follow-up (4 1/2 to 15 years) was available for three patients; all three remained healthy.