Study for the ascitic fluid in cirrhotic patients for diagnosis of spontaneous bacterial peritonitis [SBP]

The material of this study comprised 52 cirrhotic ascitic patients selected from in-patient medical department Mansoura University Hospital. From our study 9.6% of cases, [5/52] were proved to have S.B.P. and 11.5% of then [6/52] had C.N.N.A. So the overall prevalence might be considered 21.2%. Abdominal pain and generalized tenderness are of a more differential diagnostic importance than fever because they are more common in S.B.P. than in C.N.N.A. while fever lacked this differential diagnostic value. S.B.P. and its variant C.N.N.A. occured more commonly in cases with advanced cirrhosis and ascites. Also, ascitic fluid total and differential leucocytic count, lowered ascitic fluid PH and lower ascitic glucose content and decreased ascitic fluid/blood glucose ratio are specific criteria for S.B.P. Lowered ascitic PH and lowered aacitic fluid/blood glucose ratio are more intimate ascitic fluid parameters for ascitic fluid culture positivity. HBsAg positivity, lowered serum albumin and high serum alkaline phosphatase are additional criteria offered by the results of our study. Although the number of culture positive cases were few, yet they were dominantly gram-negative bacilli [E.Coli] which may suggest an enteric origin. A future research for all previously mentioned data in a rather larger group of cases for a longer time is suggested to make a good chance for assessment of the dominant organism and the most suitable chemotherapeutic agent, on side, and the most propable perpetuating factors for the development of this serious complication with high mortality in cirrhotic patients and to put a good scheme for prophylaxis on the other side