A 3-year-old child with known steroid-sensitive nephrotic syndrome presents with sudden onset of vomiting, severe abdominal pain, and fever. On examination, there is diffuse abdominal tenderness with guarding. The most likely cause is:

• A Acute appendicitis
• B Spontaneous bacterial peritonitis ✓
• C Renal vein thrombosis
• D Intussusception

Explanation

Spontaneous bacterial peritonitis is a well-recognized complication of nephrotic syndrome due to loss of immunoglobulins and edema fluid acting as a culture medium. It presents with fever, abdominal pain, and peritoneal signs. Streptococcus pneumoniae is the most common organism. While appendicitis is possible, the loss of immunoglobulins in nephrotic syndrome makes spontaneous peritonitis the most likely diagnosis in this context.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.