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[Intraperitoneal infections and immunosuppression (author's transl)].

The growing number of patients showing a restricted immune defence, also causes the surgeon to be faced with big problems; particularly in the case of intraperitoneal infections. In case of peritonitis the organism may dispose of various opportunities of immune defence involving the local limitation by adhesions, phagocyte activity, humoral and cellular immunity. Deficiencies in immune defence (congenital, acquired or iatrogenically induced) will change symptoms, diagnosis and therapy of intraperitoneal infections. Due to the lack of segmental granulocytes in patients with restricted immune defence there are frequently no symptoms of intraperitoneal infections, such as abdominal tenderness and pain. The diagnostic lavage of the abdominal cavity should be applied early. The therapy hardly differs from the general treatment of peritonitis in normal patients. The changed germ spectrum among them opportunistic germs, viruses, parasites amd mycetes, required a modified application of antibiotics. The prognosis of peritonitis in patients with restricted immune defence depends on the etiology of the infection and the degree of immunosuppression. At present a mortality rate of up to 70% is still registered.