From the Pharynx to the Abdomen: A Case of Primary Peritonitis

• Autor(a) principal: Varela, Miguel Lourenço
• Data de Publicação: 2018
• Outros Autores: Mogildea, Mihail, Moreno, Ignacio, Nunez, Daniel
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10053
• topic: Peritoneal Lavage; Peritonitis; Shock; Septic; Streptococcus pyogenes; Tonsillitis; Choque Séptico; Lavagem Peritoneal; Peritonite; Streptococcus pyogenes; Tonsilite

Primary peritonitis usually occurs in patients with comorbidities previously diagnosed with ascites. However, a primary peritoneal infection in previously healthy patients may also ensue. There has been an increase in reported cases of primary peritonitis due to Streptococcus pyogenes affecting mostly women. It usually presents as a severe acute abdominal pain, which prompts surgical exploration. Although infected ascitic fluid is seen, there is no rupture. In this article, we present a case of primary peritonitis due to Streptococcus pyogenes which rapidly evolved to septic shock and acute respiratory distress syndrome. The abdominal and pelvic computed tomography at admission showed no ascitic fluid. However, a few hours later, during surgical exploration, purulent ascitic fluid was seen throughout the abdominal cavity. It is important to be aware of this rapid accumulation of ascitic fluid, even without visceral perforation, as peritoneal lavage may be warranted to contain the infection.