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Spontaneous bacterial peritonitis caused by a viridans Streptococcus or Neisseria perflava
Abstract:
Eight patients had nine episodes of presumed spontaneous bacterial peritonitis (SBP) caused by commensal bacteria that usually inhabit the oropharynx, including Neisseria perflava and the viridans streptococci Streptococcus milleri, Streptococcus mitis, and Streptococcus sanguis. Nonpurulent ascites (ascitic fluid WBC count, less than 1,000/cu mm) was present in four episodes, possibly caused by either bacterial colonization or early peritonitis; purulent ascites was present in five episodes. None died of their infection, and three episodes remitted without treatment. Poor condition of gums and teeth may play a pathogenic role in SBP caused by these bacteria.
Insights
Spontaneous bacterial peritonitis (SBP) can be caused by oropharyngeal bacteria like Neisseria and viridans streptococci. Poor oral hygiene may contribute to SBP development, but outcomes are often favorable.
Area of Science:
- Microbiology
- Infectious Diseases
- Gastroenterology
Background:
- Spontaneous bacterial peritonitis (SBP) is a serious infection, typically caused by gut-derived bacteria.
- The role of oropharyngeal bacteria in SBP is less understood.
Observation:
- Nine episodes of presumed SBP in eight patients were linked to oropharyngeal commensal bacteria.
- These included Neisseria perflava and viridans streptococci (Streptococcus milleri, Streptococcus mitis, Streptococcus sanguis).
- Ascites characteristics varied, with nonpurulent fluid in four episodes and purulent fluid in five.
Findings:
- None of the patients died from these SBP episodes.
- Three episodes resolved spontaneously without antibiotic treatment.
- A poor condition of gums and teeth was suggested as a potential contributing factor.
Implications:
- Oropharyngeal bacteria represent an alternative source for SBP pathogens.
- Oral health status may be a modifiable risk factor for SBP.
- Further research is warranted to elucidate the pathogenesis and optimal management of SBP caused by these organisms.