Acute abdomen with findings of pneumococcal peritonitis

A healthy 20-year-old man was admitted with abdominal pain and fever. He had signs of peritoneal irritation, and blood tests showed elevated infection markers. Laparoscopy revealed purulent peritonitis of unclear cause. Blood cultures grew Streptococcus pneumoniae. He improved rapidly with antibiotics. This case highlights a rare manifestation of pneumococcal disease – peritonitis in an unusual subject; a young, previously healthy patient without risk factors. Following recovery, he was vaccinated against pneumococci.