Primary Peritonitis in Children and Infants Referred to Hospitals Affiliated to Shiraz University of Medical Sciences

Considering the great advances regarding the diagnosis and treatment of peritonitis and with respect to the prevalence of patients with primary peritonitis referred to hospitals affiliated to Shiraz university of Medical sciences, this study was performed to evaluate the predisposing and prognostic factors of this condition in children during the years 1982-1992 The descriptive protocol of this study was performed on 1 month to 14 years old children with a diagnosis of primary peritonitis in children wards of Shiraz University of Medical Science from 1982 to 1992. The patients were studied for age, gender, background illness and laboratory findings. The results were statistically analyzed by the related descriptive methods. 65 cases of primary peritonitis were identified in 50 patients during 1 O years. The ratio of boys to girls was 1.6 and the average age was 7.75 ± 3.4. The most common affected group (41%) was the age group 3-6 years. The most significant clinical findings were fever, abdominal pain and abdominal distension, and stomachache. In addition increased number of leukocytes and neutrophilia were helpful in its diagnosis. A weak relationship was found for Gram staining of peritoneal fluid and its culture and blood and urine culture. In more than half of the patients, the culture result for peritoneal fluid was negative. Almost in all patients there existed a background illness (nephrotic syndrome, hepatic disorders and/or urinary tract infection), but in those patients with nephrotic syndrome consuming prednisolone, primary peritonitis was unusual. Escherechia coli ( 46%) was the most common microorganism isolated from peritoneal fluid. Combination of ampicillin and gentamicin was very effective in 97% of cases consumed for a period of 4 to 18 days (an average of 9.2 ± 2.6 days) and in none of the cases, no mortality was reported as a result of infection.