Intraabdominal infections clinical presentation

Describe the clinical presentation typically seen with primary and secondary intraabdominal infections. 

Intraabdominal infections have a wide spectrum of clinical features. Peritonitis usually is easily recognized, but intraabdominal abscess often may continue for long periods of time. Patients with primary and secondary peritonitis present quite differently. 

Intraabdominal infection presents in many different ways and with a wide spectrum of severity. The antibiotic regimen employed and duration of treatment depend on the specific clinical circumstances (i.e., the nature of the underlying disease process and the condition of the patient). 

Intraabdominal infections have a wide spectrum of clinical features often depending on the specific disease process, the location and the magnitude of bacterial contamination, and concurrent host factors. Patients with primary and secondary peritonitis present quite differently (Table 42-3). If peritonitis continues untreated, the patient may experience hypovolemic shock from fluid loss into the peritoneum, bowel wall, and lumen. This may be accompanied by generalized sepsis. Intraabdominal abscess may pose a diagnostic challenge as the symptoms are neither specific nor dramatic. 

Increasing the coverage of antimicrobial therapy is generally necessary in mixed infections where multiple organisms are likely to be present, such as intraabdominal and female pelvic infections in which a variety of aerobic and anaerobic bacteria may produce disease. Another clinical situation in which increased spectrum of activity is desirable is with nosocomial infection. 

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