Synonym: spontaneous peritonitis, autonomic bacterial peritonitis
Criteria for the diagnosis of primary peritonitis:
(1) presence of diffuse peritonitis
(2) exclusion of visceral cause (intraperitoneal lesion) such as diverticulitis, appendicitis, penetrating trauma, peptic ulcer, etc
(3) exclusion of chemical peritonitis
Since the diagnosis is one of exclusion there needs to be a complete workup. Inadequate culturing can miss some pathogens.
Risk factors for primary peritonitis:
(1) nephrotic syndrome (a cause of acquired hypogammaglobulinemia)
(2) other causes of immunodeficiency
(3) ascites (spontaneous bacterial peritonitis)
(4) umbilical sepsis in neonates
(5) other source of infection (sepsis, urinary tract iinfection, pulmonary tuberculosis, etc)
Pathogens associated with primary peritonitis include:
(1) Group A streptococcus
(2) Streptococcus pneumonia
(3) Hemophilus species
(4) Listeria
(5) Salmonella
(6) Brucella
(7) Mycobacterium tuberculosis
(8) Pasteurella
(9) Neisseria meningitidis
(10) Fusobacterium necrophorum
(11) Klebsiella species
(12) E. coli
and others
