Primary peritonitis usually occurs in patients with comorbidities but very rarely can also occur in healthy patients. These rare cases have been published in increasing number and have higher incidence in women. This article refers to the case of a previously healthy 47-year-old woman who presented to the emergency room with acute abdomen, fever, and diarrhea that rapidly progressed to septic shock. She underwent exploratory laparoscopy, converted to laparotomy in attempt to exclude an intra-abdominal septic focus. Only purulent peritonitis with fibrin-purulent membranes was observed and the diagnosis of primary peritonitis was assumed. Peritoneal liquid culture revealed Streptococcus pneumoniae and then adjusted antibiotic therapy was started. There was postoperative clinical improvement. A systematic review of all PubMed published cases of primary peritonitis in healthy adults from 2008 to 2018 was performed, comparing demographic data, clinical presentation, imaging findings as well as their treatment and respective outcome. 


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How to Cite
FERNANDES, Sara et al. PRIMARY PNEUMOCOCCAL PERITONITIS IN A HEALTHY WOMAN: CASE REPORT AND A LITERATURE REVIEW OF THE LAST 10 YEARS. Revista Portuguesa de Cirurgia, [S.l.], n. 49, p. 82-87, jan. 2021. ISSN 2183-1165. Available at: <>. Date accessed: 22 june 2024. doi:
Clinical Case