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Concomitant pneumococcal appendicitis, peritonitis, and meningitis
Archives of Surgery (Chicago, Ill. : 1960)
|August 1, 1976
Abstract:
A 9-year-old boy developed pneumococcal meningitis and peritonitis following appendectomy. Subsequent pathologic examination showed Gram-positive diplococci in the appendix. Cultures of the peritoneal fluid, blood, and spinal fluid showed Diplococcus pneumoniae. The experience illustrates the danger of assuming that all pneumococcus peritonitis is the primary variety and the advisability of routine Gram stain of the peritoneal fluid at operation in order to select the appropriate antibiotic.
Insights
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.
- 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.