Spontaneous Bacterial Peritonitis Associated with Cervicomedullary Tumor: A case report

ABSTRACT

Spontaneous bacterial peritonitis(SBP) is a diffuse bacterial infection of peritoneum without an apparent intra-abdominal source of infection. Initially, it was believed to be associated with an alcholic liver cirrhosis, however, its clinical spectrum has been broadened and now it is thought to be a variant syndrome rather than an unique complication of liver cirrhosis. A 25 year old quadriparetic man with a low-grade astrocytoma of cervicomedullary junction underwent a partial resection of tumor and a course of radiation therapy. While recieving rehabilitation therapy, the patient developed sudden abdominal pain, constipation and fever. The laboratory findings including CBC, plain abdominal X-rays, gastroduodenal endoscopy, abdominal ultrasonography were not specific. Physical examination revealed rebound tenderness over the epigastric region and signs suggesting paralytic ileus. A diagnostic peritoneal lavage was performed and its result was compatible with SBP even though no specific orgnisms were identified. The patient was taken parenteral antibiotics. On the 13th day of treatment, his symptoms and physical signs were subsided and antibiotics were discontinued. The patient remained symptom free until rehabilitation therapies were completed.