Pathophysiology, Clinical manifestation and Diagnosis of Peritonitis

Intra-abdominal infection can be caused by various sources. Primary peritonitis or spontaneous bacterial peritonitis (SBP) is an ascetic infection. Peritonitis has been categorized as primary, secondary, tertiary or in patients with continuous dialysis. Frequent symptoms include fever, abdominal pain, nausea, vomiting, and diarrhea, and fever, abdominal pain with altered mental status in patients with cirrhosis. Patients with symptoms of ascites should undergo paracentesis to confirm SBP.Frequently isolated bacterial pathogens include gut flora, coagulase negative staphylococci, and nosocomial multidrug resistant organisms in tertiary peritonitis. Cefotaxime 2 g intravenously every eight hours produce excellent ascetic fluid levels, with supported measures to correct electrolyte imbalance. It is important to diagnose SBP early; delay in diagnosis may result in septic shock. High mortality and decreased survival by approximately 8 percent for each hour of delay in starting antibiotics in patients with septic shock.