Marin Cuartas Tomas, Nasri Ahmad Farid, Bollmann Stefan
Allgemein- und Viszeralchirurgie, HELIOS Klinik Attendorn: Akademisches Lehrkrankenhaus der Philipps-Universität Marburg, Attendorn, Deutschland.
Dtsch Med Wochenschr. 2025 Jan;150(1-02):44-47. doi: 10.1055/a-2418-2842. Epub 2024 Dec 11.
A 59-year-old female patient with an unremarkable medical history presented with watery diarrhea, severe lower abdominal pain, and fever for approximately 7 days. Physical examination revealed a distended abdomen, bowel sounds were absent, and there was an acute abdomen with generalized guarding and significantly elevated inflammatory markers.
Abdominal computed tomography showed significant ascites and signs of peritonitis. Exploratory diagnostics were indicated. A laparoscopy was performed, which revealed diffuse purulent peritonitis. Organ perforation or other reasons for a peritonitis were excluded.
Bacteriological examination and blood cultures showed β-hemolytic group A streptococci, leading to the diagnosis of spontaneous bacterial peritonitis caused by streptococci. The patient was treated with antibiotics, progressively recovered, and was discharged symptom-free and without sequelae.
Primary spontaneous bacterial peritonitis caused by is a rare cause of acute abdomen. An early diagnosis and immediate antibiotic therapy are crucial for prognosis.
一名59岁女性患者，既往病史无异常，出现水样腹泻、严重下腹痛及发热约7天。体格检查发现腹部膨隆，肠鸣音消失，存在急腹症，有全腹压痛，炎症指标显著升高。
腹部计算机断层扫描显示大量腹水及腹膜炎体征。需进行探索性诊断。遂行腹腔镜检查，结果显示弥漫性化脓性腹膜炎。排除了器官穿孔或其他导致腹膜炎的原因。
细菌学检查及血培养显示A组β溶血性链球菌，诊断为链球菌所致自发性细菌性腹膜炎。患者接受抗生素治疗后逐渐康复，出院时无症状且无后遗症。
由[此处原文可能缺失相关内容]引起的原发性自发性细菌性腹膜炎是急腹症的罕见病因。早期诊断及立即使用抗生素治疗对预后至关重要。
