PRIMARY GROUP-A STREPTOCOCCAL PERITONITIS

Primary peritonitis caused by Group A B-haemolytic streptococci (GAS) is extremely rare and is usually only seen in the presence of underlyi ng disease. This report describes the case of a previously fit young w oman who developed primary GAS peritonitis. She had a laparotomy perfo rmed at which large amounts of intra-peritoneal pus was identified but no focus of infection was found. Broad spectrum antibiotics were init ially used, these were changed to intravenous benzylpenicillin when GA S was isolated. She made a good recovery and was discharged 2 weeks af ter admission on oral amoxycillin. The organism was serotyped as T3/M3 /R3 (opacity factor negative) and it is interesting that the same sero type was isolated from a throat swab taken from her daughter. We also discuss the possible routes of infection and the epidemiology of invas ive GAS disease.