Pneumococcal peritonitis in previously healthy adults: case report and review.

We report a case of primary pneumococcal peritonitis in a young woman with no predisposing features, and we review 26 other cases of pneumococcal peritonitis in previously healthy adults. This disease is very rare in adults without cirrhosis, ascites, nephrotic syndrome, autoimmune disease, or immunocompromise. It occurs almost exclusively in women, and in most of these patients, there is a probable genital tract source of the organism. A few cases are associated with acute appendicitis. Although pneumococcal peritonitis was usually fatal in the preantibiotic era, with antibiotic therapy and surgical intervention the outcome for patients with this infection is excellent.