Peritonitis

Clinical Presentation

Primary peritonitis

• See Spontaneous bacterial peritonitis

Secondary peritonitis

• Secondary to 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-negatives (ESBLs), and Candida
• Can also be aseptic without infection but with ongoing inflammation

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 control