[Pneumococcal peritonitis. An unusual diagnosis in gynecology]

The authors, having had a case of primary pneumococcal peritonitis, review the features of this pathological condition which has become rare, and of gynaecological pneumococcal infections. Pneumococcal peritonitis presents as a very serious peritonitis and the usual diagnosis that is first made is peritonitis due to appendicitis. Pneumococcal peritonitis can be primary but it is possible that it is often secondary to genital pneumococcal infections. Treatment should always be by laparotomy to confirm the diagnosis, with a peritoneal toilet which is needed in order to stop a pelvic abscess developing. Antibiotics, which are usually of the penicillin group, should be given for at least 15 days. The treatment can be varied in those rare cases where cirrhotic ascites or serious nephrotic syndromes develop in children. Putting in drains and removing the appendix when it is normal are both useless.