title: Primary group A streptococcal peritonitis.
abstract: Primary peritonitis caused by Group A beta-haemolytic streptococci (GAS) is extremely rare and is usually only seen in the presence of underlying disease. This report describes the case of a previously fit young woman who developed primary GAS peritonitis. She had a laparotomy performed at which large amounts of intra-peritoneal pus was identified but no focus of infection was found. Broad spectrum antibiotics were initially used, these were changed to intravenous benzylpenicillin when GAS was isolated. She made a good recovery and was discharged 2 weeks after admission on oral amoxycillin. The organism was serotyped as T3/M3/R3 (opacity factor negative) and it is interesting that the same serotype was isolated from a throat swab taken from her daughter. We also discuss the possible routes of infection and the epidemiology of invasive GAS disease.
authors.affiliation: Department of Infectious Diseases and Medicine, Royal Hallamshire Hospital, Sheffield, England.
authors.forename: J C
authors.initials: JC
authors.lastname: Graham
authors.forename: P J
authors.initials: PJ
authors.lastname: Moss
authors.forename: M W
authors.initials: MW
authors.lastname: McKendrick
mesh_terms: D000208:Acute Disease; D000284:Administration, Oral; D000328:Adult; D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007813:Laparotomy; D010400:Penicillin G / Q000008:administration & dosage / Q000627:therapeutic use; D010529:Peritoneal Cavity / Q000382:microbiology; D010538:Peritonitis / Q000188:drug therapy / Q000382:microbiology*; D010614:Pharynx / Q000382:microbiology; D012703:Serotyping; D013290:Streptococcal Infections / Q000188:drug therapy / Q000382:microbiology*; D013297:Streptococcus pyogenes / Q000145:classification / Q000302:isolation & purification; D013492:Suppuration / Q000382:microbiology; D014069:Tonsillitis / Q000382:microbiology
chemical_list: D000658:Amoxicillin; D010400:Penicillin G