Refers to acute inflammation and subsequent infection of intestinal diverticula, usually of the sigmoid colon, affecting ~5% of patients with diverticulosis
Surgical/gastroenterology consultation for frank perforation, obstruction or fistula and refractory disease
Significant laboratory abnormalities may be absent
Blood cultures in severely ill and health care associated complicated infections; intra-operative cultures not needed unless hospital acquired or significant antibiotic exposure
Procalcitonin (PCT) not usually useful
If diarrhea (~25%), GPMP can be used to rule out other infectious etiologies (e.g. CDI, Salmonella spp.) but is unnecessary if diverticulitis is clear on imaging
Presence of colonic flora on urine culture suggests a colo-vesical fistula
Uncomplicated disease and absence of:
severe pain or diffuse peritonitis
significant SIRS (two or more of: Temperature >38°C or <36°C; Heart rate >90/min; Respiratory rate >20/min; White blood cell count >12,000/mm3 or <4,000mm3)
intolerance of oral intake
previous treatment failure
multiple co-morbidities
significant immunosuppression
Presence of frank perforation, phlegmon, abscess, obstruction or fistula
Pre-operative fecal peritonitis
Bacteremia from diverticulitis as a source
Usual Organisms
Less Common Organisms
Organisms of Interest in IAI