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

Authors

  • Miguel Lourenço Varela Serviço de Medicina Interna 1. Centro Hospitalar Universitário do Algarve. Unidade de Faro. Faro. Serviço de Medicina Intensiva 1. Centro Hospitalar Universitário do Algarve. Unidade de Faro. Faro. https://orcid.org/0000-0002-8689-1064
  • Mihail Mogildea Serviço de Medicina Interna 1. Centro Hospitalar Universitário do Algarve. Unidade de Faro. Faro.
  • Ignacio Moreno Serviço de Medicina Interna 1. Centro Hospitalar Universitário do Algarve. Unidade de Faro. Faro.
  • Daniel Nunez Serviço de Medicina Intensiva 1. Centro Hospitalar Universitário do Algarve. Unidade de Faro. Faro.

DOI:

https://doi.org/10.20344/amp.10053

Keywords:

Peritoneal Lavage, Peritonitis, Shock, Septic, Streptococcus pyogenes, Tonsillitis

Abstract

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.

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Published

2018-12-28

How to Cite

1.
Varela ML, Mogildea M, Moreno I, Nunez D. From the Pharynx to the Abdomen: A Case of Primary Peritonitis. Acta Med Port [Internet]. 2018 Dec. 28 [cited 2022 Nov. 30];31(12):774-7. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10053

Issue

Section

Case Report