Chapter 77. Intraabdominal Infections
Which of the following would be considered a primary intraabdominal infection?
A. A patient with small bowel obstruction and peritonitis after receiving chemotherapy
B. A patient who was knifed in the abdomen with rupture of the intestine
C. Peritonitis in a patient undergoing peritoneal dialysis
D. A patient who presents with a perforated GI ulcer
Option A: Incorrect. A small bowel obstruction is a cause of secondary peritonitis due to perforation.
Option B: Incorrect. An intraabdominal trauma is a cause of secondary peritonitis due to perforation.
Option C: Correct. Both spontaneous bacterial peritonitis from cirrhosis and peritonitis secondary to CAPD are types of primary peritonitis.
Option D: Incorrect. A perforated GI ulcer is a cause of secondary peritonitis.
In secondary peritonitis, bacteria enter the peritoneum by which of the following mechanisms?
A. Via a peritoneal dialysis catheter
B. Via perforation of the GI tracts
C. Via transmigration through the bowel wall
D. Via transmigration through the bloodstream
Option A: Incorrect. Peritoneal dialysis catheters are a cause of primary peritonitis.
Option B: Correct. Secondary peritonitis is due to a perforation of the GI tract or female genital tract.
Option C: Incorrect. Primary peritonitis (spontaneous bacterial peritonitis) is caused by transmigration of bacteria through the bowel wall.
Option D: Incorrect. Secondary peritonitis is due to a perforation of the GI tract or female genital tract.
Which is most appropriate for the initial treatment of community-acquired, high-severity, complicated intraabdominal infections?
Option A: Incorrect. Fluoroquinolones are not recommended for the initial treatment of high risk or high severity infections.
Option B: Incorrect. Single agent cephalosporins are only recommended for mild-to-moderate infections.
Option C: Incorrect. Oral antimicrobials are inappropriate for the initial treatment of high risk or high severity infections.
Option D: Correct. Single agent extended-spectrum penicillins with β-lactamase inhibitors are as effective as combinations of aminoglycosides or fluoroquinolones with antianaerobic agents. The intravenous route is also the ...