J Korean Med Sci.  2012 May;27(5):553-555. 10.3346/jkms.2012.27.5.553.

Unusual Primary Peritonitis due to Streptococcus pyogenes in a Young Healthy Woman

• Park JY
• Moon SY
• Son JS
• Lee MS
• Jung MH

• KMID: 1372800
• DOI: http://doi.org/10.3346/jkms.2012.27.5.553

Abstract

We describe the first case of primary peritonitis in Korea of a healthy person due to Streptococcus pyogenes. In the absence of comorbid conditions, such as liver cirrhosis, immunosuppression, or nephrotic syndrome, primary peritonitis is uncommon in a young healthy woman. Abdomen computed tomography revealed ascites in the lower abdomen and peritoneal enhancement suggesting peritonitis. In diagnostic laparoscopy, purulent ascites was found in the pelvic cavity but both ovaries and fallopian tubes were intact. There were no intra-abdominal abnormalities such as bowel perforation, appendicitis, or necrosis. The reports of blood culture, ascites culture, and cervical swab culture confirmed S. pyogenes. After use of antibiotics, the patient was cured and discharged without sequelae.

Keyword

Peritonitis, Primary; Streptococcus pyogenes

MeSH Terms

Adult
Anti-Bacterial Agents/therapeutic use
Female
Humans
Laparoscopy
Peritonitis/*diagnosis/drug therapy/microbiology
Streptococcal Infections/*diagnosis/drug therapy/microbiology
Streptococcus pyogenes/*isolation & purification
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 CT finding of the abdomen. (A) CT on admission demonstrated ascites, small-bowel dilatation, and peritoneal enhancement (arrow) suggesting acute peritonitis. (B) Follow up image on discharge showed decreased ascites and improving swelling of the intestinal wall.

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  Fig. 2 Laparoscopic finding. (A) Purulent ascites (arrow) was found in pelvic cavity. (B) Intact fallopian tubes and edematous intestinal wall were seen.

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