Concomitant acute lupus erythematosus and primary pneumococcal peritonitis.

The acute surgical abdomen, a synonym for peritonitis requiring surgical intervention, can be mimicked by lupus peritonitis and, in children, by pneumococcal peritonitis. The former is best treated by systemic steroids and, the latter by penicillin; neither is well served by surgical intervention. We have reported here a young woman with the concomitant occurrence of both conditions. If peritoneal tap and immediate bacteriologic gram staining of recovered aspirate were carried out in patients with a history of acute lupus, such similar cases could be detected preoperatively. An attempt at antibiotic treatment could then be instituted as a first measure.