Streptococcus pneumoniae primary peritonitis mimicking acute appendicitis in an immunocompetent patient: a case report and review of the literature
Abstract Introduction Primary peritonitis without an identifiable intra-abdominal source is extremely rare in healthy individuals; it is commonly seen in cases of nephrotic syndrome, cirrhosis and end-stage liver disease, ascites, immunosuppression, and inflamed peritoneum due to pre-existing autoim...
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doaj-312625f4a9994bbbb3a8fa30ef78d3a32020-11-25T03:35:56ZengBMCJournal of Medical Case Reports1752-19472019-04-011311610.1186/s13256-019-2038-3Streptococcus pneumoniae primary peritonitis mimicking acute appendicitis in an immunocompetent patient: a case report and review of the literatureFrancesco Cortese0Pietro Fransvea1Alessandra Saputelli2Milva Ballardini3Daniela Baldini4Aldo Gioffre5Roberto Marcello6Gabriele Sganga7Emergency Surgery and Trauma Care Unit – St Filippo Neri HospitalFaculty of Medicine and Psychology, University of Rome “La Sapienza”, St. Andrea’s HospitalFaculty of Medicine and Psychology, University of Rome “La Sapienza”, St. Andrea’s HospitalAnatomical Pathology – St Filippo Neri HospitalAnatomical Pathology – St Filippo Neri HospitalEmergency Surgery and Trauma Care Unit – St Filippo Neri HospitalDiagnostic and Interventional Radiology Unit – St Filippo Neri HospitalUOC Chirurgia d’Urgenza, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic UniversityAbstract Introduction Primary peritonitis without an identifiable intra-abdominal source is extremely rare in healthy individuals; it is commonly seen in cases of nephrotic syndrome, cirrhosis and end-stage liver disease, ascites, immunosuppression, and inflamed peritoneum due to pre-existing autoimmune and oncological conditions. Case presentation We present the case of a 68-year-old Caucasian woman operated on due to acute abdomen with a provisional diagnosis of acute appendicitis. During the operation a small amount of free intra-abdominal fluid was found. Her uterus, ovaries, and fallopian tubes were macroscopically normal. Therefore, with the suspicion of appendicitis, appendectomy was performed. Her blood cultures were negative while peritoneal fluid was positive for capsulated form of Streptococcus pneumoniae. A 30-day follow-up was performed and she was asymptomatic without any sign of infection. Discussion Streptococcus pneumoniae commonly causes upper respiratory tract infection and cutaneous infections. It very rarely causes gastrointestinal infection and it is very rarely responsible for primary peritonitis and septic shock syndrome. Conclusion Pneumococcal peritonitis has a rare occurrence and represents a clinical challenge because of its subtle and non-specific clinical findings. The interest in our case lays in the relatively rare diagnosis of primary peritonitis mimicking acute appendicitis.http://link.springer.com/article/10.1186/s13256-019-2038-3Primary peritonitisStreptococcus pneumoniaeAcute abdomen |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Francesco Cortese Pietro Fransvea Alessandra Saputelli Milva Ballardini Daniela Baldini Aldo Gioffre Roberto Marcello Gabriele Sganga |
spellingShingle |
Francesco Cortese Pietro Fransvea Alessandra Saputelli Milva Ballardini Daniela Baldini Aldo Gioffre Roberto Marcello Gabriele Sganga Streptococcus pneumoniae primary peritonitis mimicking acute appendicitis in an immunocompetent patient: a case report and review of the literature Journal of Medical Case Reports Primary peritonitis Streptococcus pneumoniae Acute abdomen |
author_facet |
Francesco Cortese Pietro Fransvea Alessandra Saputelli Milva Ballardini Daniela Baldini Aldo Gioffre Roberto Marcello Gabriele Sganga |
author_sort |
Francesco Cortese |
title |
Streptococcus pneumoniae primary peritonitis mimicking acute appendicitis in an immunocompetent patient: a case report and review of the literature |
title_short |
Streptococcus pneumoniae primary peritonitis mimicking acute appendicitis in an immunocompetent patient: a case report and review of the literature |
title_full |
Streptococcus pneumoniae primary peritonitis mimicking acute appendicitis in an immunocompetent patient: a case report and review of the literature |
title_fullStr |
Streptococcus pneumoniae primary peritonitis mimicking acute appendicitis in an immunocompetent patient: a case report and review of the literature |
title_full_unstemmed |
Streptococcus pneumoniae primary peritonitis mimicking acute appendicitis in an immunocompetent patient: a case report and review of the literature |
title_sort |
streptococcus pneumoniae primary peritonitis mimicking acute appendicitis in an immunocompetent patient: a case report and review of the literature |
publisher |
BMC |
series |
Journal of Medical Case Reports |
issn |
1752-1947 |
publishDate |
2019-04-01 |
description |
Abstract Introduction Primary peritonitis without an identifiable intra-abdominal source is extremely rare in healthy individuals; it is commonly seen in cases of nephrotic syndrome, cirrhosis and end-stage liver disease, ascites, immunosuppression, and inflamed peritoneum due to pre-existing autoimmune and oncological conditions. Case presentation We present the case of a 68-year-old Caucasian woman operated on due to acute abdomen with a provisional diagnosis of acute appendicitis. During the operation a small amount of free intra-abdominal fluid was found. Her uterus, ovaries, and fallopian tubes were macroscopically normal. Therefore, with the suspicion of appendicitis, appendectomy was performed. Her blood cultures were negative while peritoneal fluid was positive for capsulated form of Streptococcus pneumoniae. A 30-day follow-up was performed and she was asymptomatic without any sign of infection. Discussion Streptococcus pneumoniae commonly causes upper respiratory tract infection and cutaneous infections. It very rarely causes gastrointestinal infection and it is very rarely responsible for primary peritonitis and septic shock syndrome. Conclusion Pneumococcal peritonitis has a rare occurrence and represents a clinical challenge because of its subtle and non-specific clinical findings. The interest in our case lays in the relatively rare diagnosis of primary peritonitis mimicking acute appendicitis. |
topic |
Primary peritonitis Streptococcus pneumoniae Acute abdomen |
url |
http://link.springer.com/article/10.1186/s13256-019-2038-3 |
work_keys_str_mv |
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