Intra-abdominal infections can be classified into uncomplicated or complicated(peritonitis). Peritonitis is divided into primary, secondary, and tertiary. Tertiaryperitonitis is the less common but the most severe amo...Intra-abdominal infections can be classified into uncomplicated or complicated(peritonitis). Peritonitis is divided into primary, secondary, and tertiary. Tertiaryperitonitis is the less common but the most severe among peritonitisstratifications, being defined as a recurrent intra-abdominal infection that occurs48 h after a well-succeeded control of a secondary peritonitis. This disease has acomplex pathogenesis that is closely related to the capacity of the peritonealcavity to activate immunological processes. Patients who progress to persistentperitonitis are at an increased risk of developing several infectious complicationssuch as sepsis and multiple organ failure syndrome. Moreover, tertiary peritonitisremains an important cause of hospital death mainly among patients withassociated risk factors. The microbiological profile of organisms causing tertiaryperitonitis is often different from that observed in other types of peritonitis. Inaddition, there is a high prevalence of multidrug-resistant pathogens causing thiscondition, and an appropriate and successful clinical management depends on anearly diagnosis, which can be made easier with the use of clinical scorespresenting a good prediction value during the intensive care unit admission.Complementarily, immediate therapy should be performed to control theinfectious focus and to prevent new recurrences. In this sense, the treatment isbased on initial antimicrobial therapy and well-performed peritoneal drainage.展开更多
文摘Intra-abdominal infections can be classified into uncomplicated or complicated(peritonitis). Peritonitis is divided into primary, secondary, and tertiary. Tertiaryperitonitis is the less common but the most severe among peritonitisstratifications, being defined as a recurrent intra-abdominal infection that occurs48 h after a well-succeeded control of a secondary peritonitis. This disease has acomplex pathogenesis that is closely related to the capacity of the peritonealcavity to activate immunological processes. Patients who progress to persistentperitonitis are at an increased risk of developing several infectious complicationssuch as sepsis and multiple organ failure syndrome. Moreover, tertiary peritonitisremains an important cause of hospital death mainly among patients withassociated risk factors. The microbiological profile of organisms causing tertiaryperitonitis is often different from that observed in other types of peritonitis. Inaddition, there is a high prevalence of multidrug-resistant pathogens causing thiscondition, and an appropriate and successful clinical management depends on anearly diagnosis, which can be made easier with the use of clinical scorespresenting a good prediction value during the intensive care unit admission.Complementarily, immediate therapy should be performed to control theinfectious focus and to prevent new recurrences. In this sense, the treatment isbased on initial antimicrobial therapy and well-performed peritoneal drainage.
