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[Primary pneumococcal peritonitis in children]
F Barguellil1, N Gordah, N Ben Raies
1Laboratoire de Microbiologie, l'Hôpital Militaire d'Instruction de Tunis, Tunisie.
Insights
Primary pneumococcal peritonitis is rare, especially in children without immunodepression. This case highlights the importance of considering genitourinary infections in pediatric peritonitis, even with a normal appendix.
Area of Science:
- Pediatric Infectious Diseases
- Abdominal Infections
- Microbiology
Background:
- Primary pneumococcal peritonitis is uncommon post-antibiotic era, typically linked to immunosuppression or a clear entry point.
- Appendicitis is a common cause of peritonitis in children, often masking other diagnoses.
Abstract:
Since the advent of antibiotics primary pneumococcal peritonitis rarely occurs except in association with immunodepression and a detectable port of entry involving the lung, upper airways, or female genital tract. This clinical picture was observed in an 8-year-old girl who underwent surgery after an initial diagnosis of appendicitis-related peritonitis. Surgical exploration revealed a macroscopically and microscopically normal appendix and purulent peritoneal effusion. Culture of a peritoneal fluid specimen identified a pneumococcus sensitive to beta-lactam agents. Samples from the throat, urine, and vulva as well as blood cultures were negative. The patient responded favorably to ampicillin and gentamicine. The authors review the features of pneumococcal peritonitis and emphasize the high incidence of concomitant genital tract infection.