Peritonitis: Difference between revisions

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(Created page with "== Clinical Presentation == === Primary peritonitis === * See Spontaneous bacterial peritonitis === Secondary peritonitis === * Secondary to trauma or perforation === Te...")
 
 
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== Clinical Presentation ==
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==Clinical Manifestations==
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=== Primary peritonitis ===
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===Primary peritonitis===
* See [[Spontaneous bacterial peritonitis]]
 
   
 
*See [[Spontaneous bacterial peritonitis]]
=== Secondary peritonitis ===
 
* Secondary to trauma or perforation
 
   
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=== Tertiary peritonitis ===
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===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 ==
 
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* 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
 
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** See also STOP IT trial for 4+/-1 days of antibiotics after source control
 
 
===Peritoneal dialysis-related peritonitis===
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* See [[peritoneal dialysis-associated peritonitis]]
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== Differential Diagnosis ==
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* [[Appendicitis]]
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* [[Pneumonia]]
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* [[Diabetic ketoacidosis]]
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* [[Porphyria]]
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* [[Familial Mediterranean fever]]
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* [[Systemic lupus erythematosus]]
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* [[Uremia]]
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==Management==
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*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]]
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*Associated with peritoneal dialysis: see [[Peritoneal dialysis-associated peritonitis#Management|peritoneal dialysis-associated peritonitis]]
   
 
[[Category:Intra-abdominal infections]]
 
[[Category:Intra-abdominal infections]]

Latest revision as of 10:48, 2 June 2021

Clinical Manifestations

Primary peritonitis

Secondary peritonitis

  • Secondary to surgery, trauma, or perforation

Tertiary peritonitis

Peritoneal dialysis-related peritonitis

Differential Diagnosis

Management

References

  1. ^  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.