Spontaneous bacterial peritonitis caused by a viridans Streptococcus or Neisseria perflava

J. D. McCue

Eight patients had nine episodes of presumed spontaneous bacterial peritonitis (SBP) caused by commensal bacteria that usually inhabit the oropharynx, including Neisseria perflava and the viridans streptococci Streptococcus milleri, Streptococcus mitis, and Streptococcus sanguis. Nonpurulent ascites (ascitic fluid WBC count, less than 1,000/cu mm) was present in four episodes, possibly caused by either bacterial colonization or early peritonitis; purulent ascites was present in five episodes. None died of their infection, and three episodes remitted without treatment. Poor condition of gums and teeth may play a pathogenic role in SBP caused by these bacteria.