2019 Volume 39 Issue 7 Pages 1217-1220
A-51-year-old woman was transported to the emergency room of our hospital with a 1-week history of vomiting, diarrhea, and weakness. At admission, the patient was diagnosed as being in septic shock. A plain X-ray of the abdomen revealed intestinal edema and massive ascites. Intestinal necrosis was suspected, and emergency laparotomy was performed. The entire abdominal cavity was visualized, and approximately 2,000 mL of milky-white, purulent ascites was observed. No intestinal necrosis or intestinal perforation was noted, and only laparotomic drainage was performed. Streptococcus pyogenes (Group A) was detected in cultures of specimens of vaginal discharge, blood, and ascitic fluid. The patient underwent intensive treatment for septic shock, including dialysis, and the infection was controlled. Nonetheless, she developed muscle weakness and peripheral nervous disorders, and was diagnosed as having sepsis-induced critical illness polyneuropathy (CIP). Herein, we present a report of this case of pelvic peritonitis caused by fulminant group A Streptococci, together with a review of the literature. While the patient suffered from various serious symptoms, she recovered through operation, intensive care, and rehabilitation.
