Peritonitis: Difference between revisions

Revision as of 11:51, 3 August 2020

Clinical Manifestations

Primary peritonitis

See Spontaneous bacterial 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

Peritoneal dialysis-related peritonitis

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

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.

@@ Line 1: / Line 1: @@
-== Clinical Manifestations ==
+==Clinical Manifestations==
-=== Primary peritonitis ===
+===Primary peritonitis===
-* See [[Spontaneous bacterial peritonitis]]
+*See [[Spontaneous bacterial peritonitis]]
-=== Secondary peritonitis ===
-* Secondary to trauma or perforation
-=== Tertiary peritonitis ===
+===Secondary peritonitis===
-* Ongoing intraabdominal sepsis after appropriate treatment of secondary peritonitis
-* Organisms include resistant Gram-positives (Enterococcus, coagulase-negative Staphylococci), resistant Gram-negatives (ESBLs), and Candida
-* Can also be aseptic without infection but with ongoing inflammation
+*Secondary to surgery, trauma, or perforation
-=== Peritoneal dialysis-related peritonitis ===
+===Tertiary peritonitis===
-== Management ==
-* Primary: see [[Spontaneous bacterial peritonitis#Management|spontaneous bacterial peritonitis management]]
+*Ongoing intraabdominal sepsis after appropriate treatment of secondary peritonitis
-* Secondary:
+*Organisms include resistant Gram-positives ([[Enterococcus]], [[coagulase-negative staphylococci]]), resistant [[Gram-negative bacilli]] (ESBLs), and [[Candida]]
-** Source control
+*Can also be aseptic without infection but with ongoing inflammation
-** Broad-spectrum antibiotics
-** See also STOP IT trial for 4+/-1 days of antibiotics after source control
+===Peritoneal dialysis-related peritonitis===
+==Management==
+*Primary: see [[Spontaneous bacterial peritonitis#Management|spontaneous bacterial peritonitis management]]
+*Secondary:
+**Source control
+**Broad-spectrum antibiotics
+**See also STOP IT trial for 4+/-1 days of antibiotics after source control[[CiteRef::sawyer2015tr]]
 [[Category:Intra-abdominal infections]]