Spectrum of abdominal and pelvic infections caused by pneumococci in previously healthy adult women

Eleven cases of pneumococcal infection of abdominal and pelvic origin that occurred in previously healthy adults are described. All cases occurred in women who were admitted to a county hospital in Norway with acute abdominal symptoms such as pain, nausea, vomiting and diarrhea. Explorative laparotomy was performed in eight patients. Three patients had diffuse peritonitis and seven cases were classified as pelvic inflammatory disease; five of these seven patients had pelvic peritonitis. All patients but one were treated with antibiotics, and all survived without long-term sequelae. Although abdominal and genital infections caused by pneumococci are rare, their potential occurrence should not be neglected.