Primary Streptococcic Peritonitis

Group A streptococcal pharyngitis associated with primary peritonitis

“…The reports of GAS peritonitis and associated GAS pharyngitis were most frequent prior to the development of antibiotics in the 1940’s (table 1). Prior to the 1940’s, cases of GAS peritonitis was treated with laparotomy, incision and drainage and a variety of supportive measures such as gentian violet and antistreptococcic serum 3 9 12–17. As antibiotic use became widespread and the incidence of untreated GAS pharyngitis decreased, reports of pharyngitis associated with peritonitis also became less frequent.…”

“…Prior to the antibiotic era, primary peritonitis was commonly associated with a preceding pharyngitis (table 1). 3 9–16 In their 1926 review of streptococcal and pneumococcal peritonitis cases, Lipshutz and Lowenburg noted that pharyngitis so frequently preceded primary peritonitis that its presence often helped confirm the diagnosis 9. In 1927, Schwartz described 14 cases of primary streptococcal peritonitis, half of which grew streptococcus on throat culture 13.…”

“…In their review, a preceding upper respiratory tract infection, such as pharyngitis, was a key historical point in differentiating primary peritonitis from acute perforated appendicitis 3. The symptoms of pharyngitis proceeded the onset of peritonitis by 4 days to 3 weeks, with the majority of cases presenting with peritonitis approximately 1 week after developing pharyngitis 9 12…”