Hemophilus and Pneumococcal Peritonitis in Children With the Nephrotic Syndrome

Two children are reported whose nephrotic syndrome was complicated by peritonitis due to H. influenzae type b. In Pittsburgh, the leading organism for peritonitis in nephrosis remains D. pneumoniae with a disproportionately high incidence in black children. Although H. influenzae is a rare cause of this complication, it should be considered along with the other previously recognized etiological bacterial agents. Addendum: Since this manuscript was submitted, the child designated as Case 1 developed peritonitis once again, this time due to D. ptwumoniae. This episode occurred during November 1974 and was successfully treated with intravenously administered penicillin during a five-day hospitalization. At the time of that admission, her IgG was again only 45 mg/100 ml, suggesting that low serum antibody levels may indeed be important in the pathogenesis of Peritomtis and nephrosis.