Peritonitis
From IDWiki
Clinical Manifestations
Primary peritonitis
Secondary peritonitis
- Secondary to surgery, trauma, or perforation
Tertiary peritonitis
- Ongoing intraabdominal sepsis after appropriate treatment of secondary peritonitis
- Organisms include resistant Gram-positives (Enterococcus, coagulase-negative staphylococci), resistant Gram-negative bacilli (ESBLs), and Candida
- Can also be aseptic without infection but with ongoing inflammation
Differential Diagnosis
- Appendicitis
- Pneumonia
- Diabetic ketoacidosis
- Porphyria
- Familial Mediterranean fever
- Systemic lupus erythematosus
- Uremia
Management
- Primary: see spontaneous bacterial peritonitis management
- Secondary:
- Source control
- Broad-spectrum antibiotics
- See also STOP IT trial for 4+/-1 days of antibiotics after source control1
- Associated with peritoneal dialysis: see peritoneal dialysis-associated peritonitis
References
- ^ Robert G. Sawyer, Jeffrey A. Claridge, Avery B. Nathens, Ori D. Rotstein, Therese M. Duane, Heather L. Evans, Charles H. Cook, Patrick J. O’Neill, John E. Mazuski, Reza Askari, Mark A. Wilson, Lena M. Napolitano, Nicholas Namias, Preston R. Miller, E. Patchen Dellinger, Christopher M. Watson, Raul Coimbra, Daniel L. Dent, Stephen F. Lowry, Christine S. Cocanour, Michaela A. West, Kaysie L. Banton, William G. Cheadle, Pamela A. Lipsett, Christopher A. Guidry, Kimberley Popovsky. Trial of Short-Course Antimicrobial Therapy for Intraabdominal Infection. New England Journal of Medicine. 2015;372(21):1996-2005. doi:10.1056/nejmoa1411162.
