Peritonitis in childhood nephrotic syndrome: 1970-1980.

A retrospective review (1970 through 1980) of 351 children with idiopathic nephrotic syndrome disclosed 24 episodes of peritonitis in 19 patients. Twenty-six percent of the patients had more than one episode. Streptococcus pneumoniae was the most common agent (50%), but Escherichia coli remained important (25%). Four cases (16%) were culture-negative. Signs of peritoneal irritation were present in all patients, including the 16 children receiving corticosteroid therapy. No morphological subtype of nephrotic syndrome could be demonstrated to be at increased risk for the development of peritonitis. Significantly decreased IgG levels and an apparent susceptibility to pneumococcal infection among blacks may be important risk factors.