Abstract

PUENTE LUJAN, MJ et al. Gonococcal pelviperitonitis: a diagnostic challenge. Anales Sis San Navarra [online]. 2021, vol.44, n.1, pp.107-112.  Epub June 21, 2021. ISSN 1137-6627.  https://dx.doi.org/10.23938/assn.0931.

Neisseria gonorrhoeae is the second most common etiological agent of pelvic inflammatory disease and is currently underdiagnosed due to its asymptomatic presentation in 50% of cases. When the disease presents, it may appear in the form of acute abdomen and normal imaging tests, making it a major diagnostic challenge. We present four cases of acute gonococcal peritonitis. The main symptom was acute abdominal pain, and both the gynecological examination and complementary tests showed normal results. The only notable finding from the laparoscopy was the existence of purulent ascitic fluid. The results of the anatomical and pathological tests were all normal. Endocervical and ascitic fluid culture showed infection with N. gonorrhoeae, and in one case, concomitant infection with Chlamydia trachomatis. The definitive treatment applied was intravenous antibiotic therapy. When a sexually active young woman is diagnosed with peritonitis that has no apparent cause, it is important to rule out sexually transmitted diseases.

Keywords : Gonococcal pelviperitonitis; Pelvic inflammatory disease; Acute abdomen; Differential diagnosis.

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