ESPN 50th Annual Meeting

ESPN 2017


 
EXPERIENCE OF SPONTANEOUS BACTERIAL PERITONITIS IN CHILDREN WITH NEPHROTIC SYNDROME
EREN SOYALTIN 1 ÖNDER YAVAŞCAN 1 DEMET ALAYGUT 1 CANER ALPARSLAN 1 SEÇIL ARSLANSOYU ÇAMLAR 1 FATMA MUTLUBAŞ 1 BELDE KASAP DEMIR 2

1- IZMIR TEPECIK TRAINING AND RESEARCH HOSPITAL, PEDIATRIC NEPHROLOGY CLINIC
2- IZMIR KATIP CELEBI UNIVERSITY PEDIATRIC NEPHROLOGY CLINIC
 
Introduction:

 

Spontaneous bacterial peritonitis (SBP) is defined as a bacterial ascitic fluid infection without intra-abdominal surgically treatable source. The incidence of peritonitis has been reported that 1.4 - 16 % in children with NS. We aim to report four cases of primary peritonitis in children with NS and describe the clinical and laboratory findings.

Material and methods:

Total of 4 children, diagnosed with peritonitis, secondary to NS, in Izmir Tepecik Research Hospital between March 2014 and November 2016 were analyzed retrospectively in this study. Epidemiological, clinical, and laboratory characteristics of patients were also evaluated.

Results:

All patients were male and median age was 7. Peritonitis and NS were seen together at all of the patients but none of them have presented with peritonitis symptoms of the first episode of NS. Two patients were steroid dependent, and others were steroid sensitive. All patients presented with abdominal pain and tenderness. Only one patient showed vomiting and fever was monitored in two patients. During the admission period, severe hypoalbuminemia and proteinuria was determined in all of cases. In three cases, diagnostic paracentesis could not be undergone because their parents didn’t allow for this process.  In one case, diagnostic paracentesis performed. However, fluid culture was founded to be sterile. In one patient, Streptococcus pneumonia was isolated in blood culture. We treated patients empirically with ceftazidime and ceftriaxone. All patients showed regression in findings of peritonitis on the second and/or third day of the treatment.

Conclusions:

In conclusion, nephrotic patients presented with abdominal pain and tenderness should be considered as peritonitis.