Primary peritonitis

Key points

Idiopathic - infection from:

• Lymphatic

• Haematogenous

• Ascending vaginal

Often in presence of ascites:

• Nephrotic syndrome - Strep pneumoniae, gram -ve

• Peritoneal dialysis - Staphylococcus aureus and epidermidis

• Hepatic failure - Escherichia coli, Klebsiella pneumoniae and S. pneumoniae

• VP shunt - without CSF infection

Sterile peritonitis in:

• Systemic Lupus Erythrematosus

• Familial Mediterranean fever (missense or nonsense mutations in the MEFV Mediterranean fever gene) repeated inflammation of peritoneum, joints, pleura - secondary to production of pyrin

Investigations

PD catheter - paracentesis

USS or CT for surgical causes

Management

Vaccinations

Prophylactic antibiotics in CF

Prevention - Double cuff PD catheter + antibiotics on insertion

PD patients - Intraperitoneal antibiotics

Complications

Peritoneal membrane failure in PD after pseudomonas, candida, mycobacterium infections

Page edited by Mrs Charnjit Seehra BSc November 2024

References

Baird, Robert, and Candace A Haddock. "Primary Peritonitis." Pediatric Surgery NaT, American Pediatric Surgical Association, 2020. Pediatric Surgery Library, www.pedsurglibrary.com/apsa/view/Pediatric-Surgery-NaT/829666/all/Primary_Peritonitis.