Spontaneous bacterial peritonitis (SBP)

Spontaneous bacterial peritonitis (SBP) is defined as the infection of the ascitic fluid.

 

Presents with fever, diffuse abdominal pain in patients with liver cirrhosis along with ascitic fluid absolute neutrophil count (ANC) > 250 cells/mm3.

 

Etiologic agents are Escherichia coli (most common), Klebsiella, Streptococcus pneumoniae.

 

Diagnosis:-

1. Paracentesis with ascitic fluid absolute neutrophil count (ANC) > 250 cells/mm3.

2. Gram staining and culture of the ascitic fluid.

 

Management:-

1. 3rd generation cephalosporins (e.g. cefotaxime, ceftriaxone).

2. Albumin infusion to prevent kidney failure.

3. Prophylactic ciprofloxacin or trimethoprim/sulfamethoxazole is used to prevent SBP if ascitic fluid albumin is low.