Primary bacterial peritonitis in a previously healthy adolescent female: A case report

AbstractIntroductionAcute pneumococcal peritonitis represents an unusual entity characterized by infection in the abdominal cavity despite the absence of an obvious causative source. Patients with portal hypertension such as cirrhotics and those with nefrotic syndrome are more frequently encountered in the every day practice.Presentation of caseA 14 years old female was referred to our department by his general practitioner with a 24h history of right lower abdominal pain and fever. Clinical examination was suggestive for peritonitis and the girl was transferred to the operation room. A diagnosis of primary pneumococcal peritonitis was made on the basis of the findings during surgery and the microbiological tests. Institution of appropriate antibiotics resulted to complete recovery.DiscussionA mini literature review was performed.ConclusionPrimary bacterial peritonitis in adolescents is extremely rare. Surgeons are required to be aware of this entity

Mesenteric Lymphadenitis Presenting as Acute Abdomen in a Child with Multisystem Inflammatory Syndrome

Multisystem inflammatory syndrome in children (MIS-C) may develop as a rare complication following COVID-19. MIS-C presentation varies substantially, but fever and gastrointestinal symptoms are the most prominent. Indeed, gastrointestinal involvement may be severe enough to present as acute abdomen, posing challenges to clinicians. We present herein the case of a healthy five-year-old male who presented with fever, vomiting, and abdominal pain, resembling acute abdomen. The patient had no history of SARS-CoV-2 infection or exposure, and MIS-C diagnosis was initially surpassed unnoticed. The patient underwent exploratory laparotomy that only revealed mesenteric lymphadenitis. Postoperatively, the patient met the clinical and laboratory diagnostic criteria of MIS-C. SARS-CoV-2 exposure was serologically confirmed and MIS-C treatment was commenced, resulting in defervescence and a satisfactory outcome. In young patients presenting with acute abdomen, surgeons should be aware of MIS-C, so that earlier diagnosis and appropriate treatment are made prior to surgical interventions