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Query: UMLS:C0341503 (bacterial peritonitis)
 1,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report the case of a patient with cryptogenic cirrhosis, new onset ascites, and hyperinfection with Strongyloides stercoralis who had significant eosinophilia of the peritoneal fluid. The eosinophilia resolved with treatment of the S. stercoralis infection, and did not recur during two subsequent episodes of ascites and spontaneous bacterial peritonitis. Eosinophilic ascites is rare in parasitic infection, but it has been described in a variety of disorders which are discussed.
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PMID:Eosinophilic ascites due to hyperinfection with Strongyloides stercoralis. 198 60

Eosinophilic ascites is an uncommon clinical entity with diagnostic considerations separate from those of spontaneous bacterial peritonitis (SBP). We describe a man with documented E. coli SBP with an 80% eosinophilia in peritoneal fluid (total cell count 12,400/mm3) and no peripheral eosinophilia. Antimicrobial therapy resulted in both clinical improvement and resolution of the eosinophilia in the ascitic fluid. The possible role of associated medications and the potential importance of this syndrome are discussed.
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PMID:Eosinophilic peritonitis: an unusual manifestation of spontaneous bacterial peritonitis. 390 Jan 91

Cefamandole in combination with tobramycin was evaluated in the treatment of peritonitis as an adjunct to laparotomy and performance of the indicated surgical procedure in 88 patients. The clinical response was judged satisfactory in 91 per cent. Of four deaths, only one could be attributed to infection. Side effects noted were decreased creatinine clearance in 16 patients, increased liver enzymes in ten patients, and eosinophilia in nine patients. Microbiologic studies revealed aerobic peritonitis in 44 cultures and anaerobic in 32. Eighty-five per cent of the gram-negative and 69 per cent of the gram-positive strains were susceptible to cefamandole. Cefamandole alone or in combination with tobramycin appears to be an effective and safe antibiotic when used in appropriate doses for the treatment of bacterial peritonitis.
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PMID:Bacterial peritonitis. Protecting the high-risk patient. 637

The aim was to study in vitro regulation of the IL-5 receptor alpha (IL-5R alpha) on purified peripheral blood eosinophils from healthy subjects. The IL-5R alpha was down-regulated, in a dose-dependent manner, by recombinant IL-5 and GM-CSF, with IL-5 being most potent. This down-regulation was not induced by autocrine release of GM-CSF or IL-5, respectively. Incubation of eosinophils with cell-free peritoneal dialysis fluid (PF) collected from a patient with peritoneal fluid eosinophilia (PFE), induced up-regulation of the proportion of CD69 positive eosinophils, in parallel with down-regulation of the proportion of IL-5R alpha positive eosinophils. Experiments with neutralizing antibodies against IL-5 and GM-CSF, revealed that IL-5 was the principal cytokine responsible for the down-regulation of the IL-5R alpha. When eosinophils were incubated with PF collected from the same patient in remission or with PF collected from a newly started patient or a patient with bacterial peritonitis, less down-regulation of the IL-5R alpha was observed. In conclusion our data indicate that IL-5, as opposed to its proposed action on eosinophil progenitors, down-regulates the IL-5R alpha chain on mature eosinophils. We therefore suggest that an IL-5 driven inflammation generates an eosinophil tissue phenotype that is characterized by a low IL-5R alpha expression. These aspects of IL-5 action on IL-5R alpha expression could gain new insights into the mechanisms of specific immuno-modulatory therapies, such as anti-IL-5.
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PMID:Regulation of the interleukin-5 receptor alpha-subunit on peripheral blood eosinophils from healthy subjects. 1251 89

Eosinophilic gastroenteritis (EG) is a rare disease characterized by eosinophilic infiltration of portions of the gastrointestinal tract. Eosinophilic ascites is probably the most unusual and rare presentation of EG and is generally associated with the serosal form of EG. Hereby, we report a case of eosinophilic ascites with duodenal obstruction in a patient with liver cirrhosis. A 50-year-old woman was admitted to our hospital because of abdominal pain, nausea, bloating, and constipation. She had a history of laparotomy because of duodenal obstruction 2 years ago. Based on clinical, radiological, endoscopic, and pathological findings, and given the excluding the other causes of peripheral eosinophilia, the diagnosis of eosinophilic gastroenteritis along with liver cirrhosis and spontaneous bacterial peritonitis was established. Based on the findings of the present case, it is highly recommended that, in the patients presented with liver cirrhosis associated with peripheral blood or ascitic fluid eosinophilia, performing gastrointestinal endoscopy and biopsy can probably reveal this rare disorder of EG.
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PMID:Eosinophilic ascites and duodenal obstruction in a patient with liver cirrhosis. 2477 56

A 59-year-old Laotian male with a past medical history of multiple myeloma on peritoneal dialysis (PD) presented with abdominal pain and peritoneal eosinophilia. He was treated empirically for bacterial peritonitis and discharged although his PD fluid did not isolate any pathogens. He soon developed a partial small bowel obstruction and his serum Strongyloides IgG was positive. After treatment with ivermectin, stool microscopic examination showed Strongyloides stercoralis larvae. This case illustrates that the differential diagnosis of peritoneal eosinophilia should include typical and atypical infections in addition to an allergic or hypersensitivity type reaction.
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PMID:Intestinal Strongyloides causing peritoneal eosinophilia in peritoneal dialysis. 2606 6

Endemic to the southwestern parts of the United States, coccidioidomycosis, also known as "Valley Fever," is a common fungal infection that primarily affects the lungs in both acute and chronic forms. Disseminated coccidioidomycosis is the most severe but very uncommon and usually occurs in immunocompromised individuals. It can affect the central nervous system, bones, joints, skin, and, very rarely, the abdomen. This is the first case report of a patient with coccidioidal dissemination to the peritoneum presenting as eosinophilic ascites (EA). A 27-year-old male presented with acute abdominal pain and distention from ascites. He had eosinophilia of 11.1% with negative testing for stool studies, HIV, and tuberculosis infection. Ascitic fluid exam was remarkable for low serum-ascites albumin gradient (SAAG), PMN count >250/mm(3), and eosinophils of 62%. Abdominal imaging showed thickened small bowel and endoscopic testing negative for gastric and small bowel biopsies. He was treated empirically for spontaneous bacterial peritonitis, but no definitive diagnosis could be made until coccidioidal serology returned positive. We noted complete resolution of symptoms with oral fluconazole during outpatient follow-up. Disseminated coccidioidomycosis can present in an atypical fashion and may manifest as peritonitis with low SAAG EA. The finding of EA in an endemic area should raise the suspicion of coccidioidal dissemination.
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PMID:Coccidioidomycosis Masquerading as Eosinophilic Ascites. 2626 62