Peritonitis: Difference between revisions

Latest revision as of 14:48, 2 June 2021

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

See peritoneal dialysis-associated peritonitis

Differential Diagnosis

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.

@@ Line 1: / Line 1: @@
-== Clinical Presentation ==
+==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===
+* See [[peritoneal dialysis-associated peritonitis]]
+== Differential Diagnosis ==
+* [[Appendicitis]]
+* [[Pneumonia]]
+* [[Diabetic ketoacidosis]]
+* [[Porphyria]]
+* [[Familial Mediterranean fever]]
+* [[Systemic lupus erythematosus]]
+* [[Uremia]]
+==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]]
+*Associated with peritoneal dialysis: see [[Peritoneal dialysis-associated peritonitis#Management|peritoneal dialysis-associated peritonitis]]
 [[Category:Intra-abdominal infections]]