Ghulam Qasim Khan Khichi, Nasim Akhtar, Muhammad Saleem Channar.
Peritonitis in children with Nephrotic Syndrome.
Pak Paed J Jan ;28(1):15-20.

Objective:- 1) To determine the frequency of peritonitis in patients of nephrotic syndrome in relation to sex and age. 2) To know various organisms causing peritonitis Design:- An observational analytical retrospective cohort study (n=300). Place and duration of study:- Pediatrics ward-2 of Quaid-e-Azam Medical College/BV Hospital, Bahawalpur. Ten years from April 1992 to April 2002. Methods:- All charts of 1-15 years patients of nephrotic syndrome were reviewed retrospectively who were admitted in unit-2 of Pediatric department of BV Hospital from April 1992 to April 2002. Cases of nephrotic syndrome were diagnosed by "a set criteria". All patients had blood collected and cultured. Peritoneal fluid was aspirated, centrifuged and sediment was used for culture and cytological examination. Frequency of peritonitis was determined in relation to different variables like age, sex. Statistical analysis was done by x2 test to determine the p-value of results. Results:- 48/300 (16%) of the nephrotic patients suffered from peritonitis during this period. Out of 209, males 33 (15.78%) developed peritonitis while 15/91 (18.51%) were females. Eight patients were 1-5 years, ten patients 6-10 years while thirty were 11-15 years old. In 21/48 (43.755%) patients peritoneal tap culture were positive while 18/48 - (37.55%) blood culture yielded organisms. Gram positive bacteremia was 20/48 (41.66%) mainly due to streptococcus pneumoniae. 4/48 (8.33%) cases had gram negative organisms. Conclusions:- Streptococcus pneumoniae was the most common organism isolated having a good response to benzyl penicillin. There was no significant change in the distribution of pathogenic organisms during the ten years period of this study.

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