Primary peritonitis and meningitis in nephrotic syndrome in Riyadh

Primary peritonitis among children with the nephrotic syndrome is increasing following a decline when antibiotics and steroids were introduced. Meningitis has not been reported in such patients. Six nephrotic children with primary peritonitis and two with pneumococcal meningitis are reported. Peritonitis occurred in relapsing long standing cases while meningitis occurred in recently diagnosed cases. Steroid therapy was not found to be a contributing factor in the causation of the septic episodes. Long standing ascites was not a precursor to the development of peritonitis. All cases had hypoproteinemia and all those tested had low plasma IgG. The pneumococcus was grown from ascitic fluid and blood in three of the peritonitis cases and streptococcus pyogenes from the throat of one. All responded to penicillin therapy.