Acute primary peritonitis in the absence of other comorbid conditions such as liver cirrhosis, immunosuppression, or nephrotic syndrome is a rare disorder in young adults. In women, ascending genital infections are thought to be a major pathogenic cause of this type of peritonitis. Pus was detected in the peritoneal cavity by abdominal paracentesis in a 27-year-old woman who had no predisposing features for severe peritonitis. Abdominal computed tomography showed perirectal edema. Laparotomy was performed, but no intra-abdominal focus of infection could be detected. The abdomen was irrigated via a subhepatic and retroperitoneal presacral approach, and broad-spectrum antibiotic therapy was started. Blood cultures revealed group A streptococci, usually a common cause of upper respiratory tract infections or erysipelas. Within a few days, the patient recovered completely and returned to normal life.
Mystery or Misery? Primary Group A Streptococcal Peritonitis in Women: Case Report
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Michael Haap, Christian S. Haas, Reinhard Teichmann, Marius Horger, Armin Raible, Georg Lamprecht; Mystery or Misery? Primary Group A Streptococcal Peritonitis in Women: Case Report. Am J Crit Care 1 September 2010; 19 (5): 454–458. doi: https://doi.org/10.4037/ajcc2009615
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