Sir.—I noted with interest the recent article of Freij and colleagues.1I have treated 15 children with primary peritonitis in the age group of 6 months to 5 years. However, unlike the management of Freij et al, I resorted to a diagnostic tap and Gram's staining of smears for determining the management. If there were pus cells but no organisms or gram-positive bacteria, then these children were treated conservatively with gentamicin, ampicillin, and metronidazole parenterally. If the amount of pus on diagnostic tap was considerable, then peritoneal lavage was done with lactated Ringer's solution with antibiotics fortification through the same needle used for the peritoneal tap. Laparotomy was advised only if there was blood or evidence of gram-negative bacteria on the smears. All the children survived the acute episode with relief of toxic symptoms over a period of 48 hours.
All these children had preceding diarrhea followed for
SHETH NP. Primary Peritonitis in Previously Healthy Children. Am J Dis Child. 1985;139(7):653. doi:10.1001/archpedi.1985.02140090015013