[Primary pneumococcal peritonitis in children].

Since the advent of antibiotics primary pneumococcal peritonitis rarely occurs except in association with immunodepression and a detectable port of entry involving the lung, upper airways, or female genital tract. This clinical picture was observed in an 8-year-old girl who underwent surgery after an initial diagnosis of appendicitis-related peritonitis. Surgical exploration revealed a macroscopically and microscopically normal appendix and purulent peritoneal effusion. Culture of a peritoneal fluid specimen identified a pneumococcus sensitive to beta-lactam agents. Samples from the throat, urine, and vulva as well as blood cultures were negative. The patient responded favorably to ampicillin and gentamicine. The authors review the features of pneumococcal peritonitis and emphasize the high incidence of concomitant genital tract infection.