Department of Endocrinology, Metabolism, Nephrology, Clinical Chemistry, and Vascular Medicine, Eberhard-Karls-University, Tübingen, Germany.
Am J Crit Care. 2010 Sep;19(5):454-8. doi: 10.4037/ajcc2009615. Epub 2009 Jul 27.
Acute primary peritonitis in the absence of other comorbid conditions such as liver cirrhosis, immunosuppression, or nephrotic syndrome is a rare disorder in young adults. In women, ascending genital infections are thought to be a major pathogenic cause of this type of peritonitis. Pus was detected in the peritoneal cavity by abdominal paracentesis in a 27-year-old woman who had no predisposing features for severe peritonitis. Abdominal computed tomography showed perirectal edema. Laparotomy was performed, but no intra-abdominal focus of infection could be detected. The abdomen was irrigated via a subhepatic and retroperitoneal presacral approach, and broad-spectrum antibiotic therapy was started. Blood cultures revealed group A streptococci, usually a common cause of upper respiratory tract infections or erysipelas. Within a few days, the patient recovered completely and returned to normal life.
急性原发性腹膜炎在不存在其他合并症的情况下，如肝硬化、免疫抑制或肾病综合征，在年轻成人中较为罕见。在女性中，上升性生殖器感染被认为是这种类型腹膜炎的主要致病原因。一位 27 岁的女性因无严重腹膜炎的诱发因素而行腹腔穿刺术，发现腹腔中有脓液。腹部 CT 显示直肠周围水肿。行剖腹术，但未发现腹腔内感染灶。通过肝下和腹膜后经直肠前间隙进行腹腔冲洗，并开始使用广谱抗生素治疗。血培养显示 A 组链球菌，通常是上呼吸道感染或丹毒的常见原因。几天后，患者完全康复并恢复正常生活。
