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Related Experiment Videos

Spontaneous bacterial peritonitis presenting as a perforated viscus

A P Swamy, J C Mangla, A May

    Journal of Clinical Gastroenterology
    |March 1, 1981
    PubMed
    Summary

    A young man developed spontaneous primary peritonitis, a rare condition, due to steroid treatment for nephrotic syndrome. This case highlights a potential complication of immunosuppression in patients with kidney disease.

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    Area of Science:

    • Gastroenterology
    • Nephrology
    • Infectious Diseases

    Background:

    • Nephrotic syndrome is a kidney disorder characterized by heavy protein in the urine.
    • Steroid therapy is a common treatment for nephrotic syndrome, but can lead to immunosuppression.
    • Peptic ulcer disease symptoms can be exacerbated by steroid use.

    Observation:

    • A young male patient with severe nephrotic syndrome presented with symptoms mimicking peptic ulcer disease.
    • The patient was undergoing treatment with corticosteroids.
    • He subsequently developed peritonitis and pneumoperitoneum, indicating intra-abdominal complications.

    Findings:

    • Laparotomy revealed B. fragilis peritonitis.
    • No evidence of gastrointestinal perforation was found.

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  • Ascites fluid culture confirmed Bacteroides fragilis as the causative agent.

    • Implications:

    • This case suggests spontaneous primary peritonitis as a potential diagnosis in immunocompromised patients presenting with peritonitis.
    • Bacteroides fragilis peritonitis can occur without perforation, particularly in patients on immunosuppressive therapy.
    • Highlights the importance of considering non-surgical causes of peritonitis in patients with nephrotic syndrome and steroid treatment.