Muhammad Abu Talib, Asim Khurshid, Khurram Rashid.
Frequency and Etiology of Peritonitis in Pediatric Nephrotic Syndrome.
Pak Paed J Jan ;45(4):401-4.

Objective: To determine the frequency and etiology of peritonitis in pediatric nephrotic syndrome Study Design: Cross sectional descriptive study. Place and Duration of Study: This study was conducted in the Department of Nephrology, Children Hospital & the Institute of Child Health, Multan from 1st July to 31st December 2017. Material and Methods: One hundred and fifty two admitted patients of nephrotic syndrome between ages 1-10 years with normal renal functions were included in the study. All of them were evaluated for detailed history, clinical examination and laboratory investigations. Spontaneous bacterial peritonitis was our primary clinical diagnosis with aid of blood and ascitic fluid laboratory analysis. Results: The frequency of spontaneous bacterial peritonitis was 27%. The mean age of patients was 6.2 +5.8 years and male to female ratio was 2:1. Patients diagnosed with peritonitis presented with abdominal pain and tenderness (95%), fever (93%) and vomiting (73%). Streptococcus pneumoniae was isolated in 19% and Escherichia coli in 7% children. Blood cultures were positive in (29%) patients of peritonitis while ascitic fluid culture was positive in 27%. Conclusion: Frequency of spontaneous bacterial peritonitis in pediatric nephrotic syndrome is 27% with male predominance. Ascitic fluid culture is positive in 27% children with peritonitis revealing pneumococcus as the most common offending agent.

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