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Concomitant pneumococcal appendicitis, peritonitis, and meningitis

M Dimond, H J Proctor

Archives of Surgery (Chicago, Ill. : 1960)

|August 1, 1976

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A boy developed pneumococcal meningitis and peritonitis after appendectomy. The appendix showed bacteria, indicating a secondary cause, not primary pneumococcus peritonitis.

Area of Science:

Infectious Diseases
Microbiology
Surgical Infections

Background:

Appendectomy is a common surgical procedure.
Pneumococcal infections can manifest in various forms, including meningitis and peritonitis.
Distinguishing primary from secondary peritonitis is crucial for effective treatment.

Observation:

A 9-year-old boy presented with meningitis and peritonitis post-appendectomy.
Pathologic examination revealed Gram-positive diplococci within the appendix.
Cultures confirmed Diplococcus pneumoniae in peritoneal fluid, blood, and spinal fluid.

Findings:

The case demonstrates secondary pneumococcal peritonitis originating from an infected appendix.
This challenges the assumption that all pneumococcus peritonitis is primary.

Related Experiment Videos

Gram stain of peritoneal fluid during surgery is vital for accurate diagnosis.

Implications:

Highlights the importance of considering secondary causes of peritonitis, even with typical pathogens.
Emphasizes the need for intraoperative Gram staining to guide antibiotic selection.
Underscores potential complications following appendectomy if underlying infections are overlooked.