Background: Spontaneous bacterial peritonitis is an uncommon condition. It has a non-specific clinical presentation which leading sometimes to an unnecessary laparotomy especially in a low income country.
Case presentation: We received a 19-months old child, with an unremarkable past medical history, admitted in our service for a 2-day history of abdominal distension and fever. She presented with guarding and abdominal tenderness. Abdominal ultrasound revealed a peritoneal effusion and signs of intestinal occlusion without obstacle to peristalsis. A blood culture revealed Streptococcus sp as etiology and we made a diagnosis of spontaneous bacterial peritonitis. The patient recovered after medical treatment.
Conclusion: Spontaneous bacterial peritonitis is a possible diagnosis that clinicians should bear in mind during investigation of an acute abdomen. Accurate initial diagnosis can avert unnecessary surgery, since treatment is medical.