Spontaneous bacterial peritonitis

ABSTRACT

Spontaneous Bacterial Peritonitis [SBP] is being diagnosed with increasing frequency as the practice of routine paracentesis in cirrhotics is becoming more common. A retrospective study at the Aga Khan University Hospital showed that the prevalence of this complication in 100 decompensated patients with chronic liver disease was 33% which is higher than reported previously. Paracentesis of ascitic fluid was performed within 24 of hours admission on all patients with no serious complications resulting from the procedure. Ascitic fluid was cultured in conventional way and was positive in 45%. Simultaneous blood cultures were positive in 15%. E. coli was the predominant organism in the blood as well as ascitic fluid. It was further shown that the patients who had ascitic fluid protein of less than 1 gm/dl and prothrombin time more than 20 seconds with a control of 13 seconds suffered repeated episodes of SBP. The mortality was 36% in patients with SBP. This study confirmed that SBP is a common complication in patients with cirrhosis admitted to hospitals and should be actively looked for and that routine paracentesis is safe and must be done in all cirrhotic patients with ascites who are admitted to hospitals