Persistent Abdominal Distension: A Clue to Spontaneous Bacterial Peritonitis

Abstract

We report a 7-year-old boy who presented with persistent abdominal distension despite appropriate therapy with corticosteroids for the first episode of nephrotic syndrome. After a thorough workup, the child was diagnosed with spontaneous bacterial peritonitis (SBP). Although fever, pain abdomen, abdominal tenderness, paralytic ileus, and altered mental status are the classical findings in SBP, concomitant steroid use in an immunocompromised host may mask many symptoms, posing diagnostic challenges.