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JCDR. 2021; 12(4): 2197-2204

An Insight of Spontaneous Bacterial Peritonitis

Mohamed Ahmed Ahmed Abdel wahed, Tarik Ibrahim Ali Zaher, Ahmed Mokhtar Ahmed Ebrahim, Ahmed Abou El khair Ahmed Badawy.


Background: Liver cirrhosis represents a terminal clinical stage of chronic liver disease.
Patients with liver cirrhosis are susceptible to a variety of complications. Ascites or
accumulation of fluid within the peritoneal cavity is one of the most common
complications. Spontaneous bacterial peritonitis (SBP) is the infection of pre-existing
ascitic fluid without evidence of a secondary infection. The diagnosis of SBP is based on
a polymorphonuclear leukocyte (PMN) count in ascitic fluid of ≥250 cells/mm3,
irrespective of whether the ascitic fluid indicates positive results on bacterial culture. After
transporting the ascitic fluid to the laboratory, the number of PMNs in this fluid is
measured. False-negative results may occur due to lysis of the PMNs during transport to
the laboratory. Manual counting of the PMN in the ascitic fluid is operator-dependent and
can delay the diagnosis. SBP leads to hospitalization of 10–30% of cirrhotic patients, and
the mortality rate in this group approaches 30%. Owing to the high mortality rate, patients
with SBP should be started on empiric, broad-spectrum antibiotics immediately. According
to the 2012 American Association for the Study of Liver Disease guidelines, in patients
with suspected SBP, empiric therapy should be initiated promptly to maximize patient

Key words: Spontaneous Bacterial Peritonitis

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