Spontaneous bacterial peritonitis in Egyptian patients with bilharzial hepatic fibrosis: bacteriological, biochemical and immunological study

ABSTRACT

20 cases of ascites were included in this study selected from patients suffering from bilharzial hepatic fibrosis [BHF] with manifestations suggestive of spontaneous bacterial peritonitis [SBP]. Ten normal persons were taken as a control group for serum C3 estimation. Positive ascitic fluid culture established the etiology of 8 cases [40%] while, no growth could be detected in 12 cases [60%]. Ascitic fluid LDH, total leucocytic count, polymorphonuclear count and lymphocytic cell count were significantly higher in culture positive group than culture negative group. Ascitic fluid pH and C3 concentration were significantly lower in culture positive cases compared to culture negative cases [P value of 0.001 and 0.000, respectively]. Also, ascitic fluid opsonic activity was significantly lower in culture positive than in culture negative group [mean = 0.062 +/- 0.052 versus 0.342 +/- 0.124 logkill]. Contrary to the typical finding in infected body fluids, the total protein content and absolute glucose content of cases with spontaneously infected ascitic fluid do not exhibit significant change in comparison with cases with negative ascitic fluid culture. In addition, serum C3 concentration was significantly lower in cases with positive ascitic fluid culture than in negative ascitic fluid culture cases [P value of 0.01]