Spontaneous bacterial peritonitis sbp is defined as an ascitic fluid infection without an evident intraabdominal surgically treatable source. Summary background spontaneous bacterial peritonitis sbp is a severe and often fatal infection in patients with cirrhosis and ascites. The occurrence of spontaneous bacterial peritonitis varies according to the studied population. It is specifically an infection of the ascitic fluid an increased volume of peritoneal fluid. The following is a list of these categories and some examples of their causes. Spontaneous bacterial peritonitis statpearls ncbi bookshelf. Abstract the most common cause of ascites is cirrhosis, followed by malignancy and tuberculosis. It is one of the most frequently encountered bacterial infections in patients with cirrhosis. Early publications emphasised the atypical features of such peritonitis and the frequency of misdiagnosis.
Kk spontaneous bacterial peritonitis is an infection that occurs in ascites, fluid in the abdomen that may develop in patients with cirrhosis. Spontaneous bacterial peritonitis sbp is the development of a bacterial infection in the peritoneum, despite the absence of an obvious source for the infection. The presence of sbp, which almost always occurs in patients with cirrhosis and ascites, is suspected because of signs and symptoms such as fever, abdominal pain, or altered mental status. Sbp is the most common infection causing renal impairment in cirrhotics 2, 3. Spontaneous bacterial peritonitis is the most frequent bacterial infection in patients with cirrhosis, followed by urinary tract infection, pneumonia, skin and soft tissue infections, and spontaneous bacteremia.
Spontaneous bacterial peritonitis, an infection of ascitic fluid, occurs in the absence of perforation of a hollow viscus or an intraabdominal inflammatory focus such as an abscess, acute pancreatitis, or cholecystitis. Spontaneous bacterial peritonitis rebel em emergency. Spontaneous bacterial peritonitis sbp is a common, serious complication in patients with cirrhosis and ascites. Core concepts recognition and management of spontaneous. The colon contains a large number of bacteria, more than. This is infected ascites fluid due to an underlying surgicallytreatable source of infection i.
Spontaneous bacterial peritonitis sbp is an infection of ascitic fluid that cannot be attributed to any intraabdominal, ongoing inflammatory, or surgically correctable condition. Chronic liver disease was documented by varices in 91%, severe histologic fibrosis or cirrhosis in 94%, splenomegaly in 91%, and past. Indeed, patients with culturenegative neutrocytic ascites have similar mortality rates as patients with confirmed spontaneous bacterial peritonitis and benefit from antibiotic. Most episodes of spontaneous bacterial peritonitis sbp are thought to result from bacterial. Spontaneous bacterial peritonitis is a common complication in patients of cirrhosis of liver8.
Several variants of this disease exist including bacterascites, culturenegative neutrocytic ascites, and secondary bacterial peritonitis. The mortality rate from primary spontaneous peritonitis is about 10% and the mortality rate from secondary peritonitis is less than 5%. Spontaneous bacterial peritonitis sbp is the most frequent and lifethreatening infection in patients with liver cirrhosis requiring prompt. Pdf ascitic calprotectin as a diagnostic marker for spontaneous. Spontaneous bacterial peritonitis sbp is a serious complication that occurs among cirrhotic patients with ascites. Ascitic calprotectin as a useful marker in the diagnosis of. Spontaneous bacterial peritonitis symptoms, diagnosis. Analysis of treatment and outcome article pdf available in the canadian journal of infectious diseases journal. The risk of developing sbp during hospitalization ranges. However, the incidence and outcome of renal dysfunction have not been particularly. The incidence of sbp ranges from 10% to 30% and mortality from 10% to. It is a bacterial infection of ascitic fluid in the absence of an adjacent, surgically amenable infection source. Criteria for sbp included a positive ascites culture and polymorphonuclear cell concentration greater than 250 cells per mm 3.
Spontaneous bacterial peritonitis in patients with. It can also occur in patients with nephrotic syndrome. Bacterial translocation, or the migration of bacteria. The peritoneum, which is an otherwise sterile environment, reacts to various pathologic stimuli with a fairly uniform inflammatory response. Derived from the greek word askos which means sack, ascites is characterized as the collection of. The causes of peritonitis can be grouped into five categories. Its prevalence in cirrhotic patients with ascites on hospital admission ranges from 10% to 30%2. Pdf background the gold standard for the diagnosis of spontaneous. Ascites is most commonly a complication of cirrhosis of the liver. Sponaneo baceemia and ponaneo baceial peionii in cihoi. Since its description in 1964 1 numerous studies, guidelines, and both national and international con.
The presence of sbp, which almost always occurs in patients with cirrhosis and ascites, is suspected because of suggestive signs and symptoms, such as fever, abdominal pain, or altered mental status, though some. Spontaneous bacterial peritonitissbp is defined as the infection of ascitic fluid without any apparent intra abdominal focus of infection in patients of cirrhosis of liver6,7. Ascitic paracentesis remains the chief diagnostic procedure. Spontaneous bacterial peritonitis sbp is associated with ascites from patients with cirrhosis highest risk patients for sbp, heart failure, or patients with systemic lupus and nephrosis. Spontaneous bacterial peritonitis sbp is the infection of ascitic fluid in the absence of any intra. Spontaneous bacterial peritonitis sbp is a common and. Pdf spontaneous bacterial peritonitis researchgate. Pdf spontaneous bacterial peritonitis is the most frequent bacterial infection in patients with cirrhosis. Merupakan peritonitis yang infeksi kumannya berasal dari penyebaran secara hematogen. Peritonitis is defined as an inflammation of the serosal membrane that lines the abdominal cavity and the organs contained therein. Diagnosis of spontaneous bacterial peritonitis indications for testing in a patient with ascites, the presence of newonset fever temperature greater than 37. Despite timely diagnosis and treatment its reported incidence in ascitic patients varies between 730%.
Treatment ascites firstline treatment for patients with ascites includes dietary sodium restriction maximum 2,000 mgd and oral diuretics spironolactone with or without furosemide. Case report spontaneous bacterial peritonitis caused by oxidase. Spontaneous bacterial peritonitis sbp is a term used to describe acute. Secondary bacterial peritonitis is more sinister and rare twenty times less common than spontaneous bacterial peritonitis. Impact of microbiological changes on spontaneous bacterial. Spontaneous bacterial peritonitis is an infection of the ascitic fluid of patients who, in general, have severe chronic liver disease. Sering disebut juga sebagai spontaneous bacterial peritonitis sbp. Recognition and management of spontaneous bacterial.
This is a core content post on spontaneous bacterial peritonitis sbp, which is an acute infection of the ascitic fluid in a patient with liver. Unlike with secondary peritonitis, where the peritoneal inflammation is often due to an identifiable infection, sbp is an infection of. Patients with suspected spontaneous bacterial peritonitis sbp and ascitic fluid pmn greater than or equal to 250 cellsmm 3 0. Spontaneous bacterial peritonitis sbp, or primary peritonitis, is when body fluid builds up in the abdominal cavity a condition called ascites and results in inflammation. Spontaneous bacterial peritonitis gastroenterology. Guadalupe garciatsao, in goldmans cecil medicine twenty fourth edition, 2012. Peritonitis ini bentuk yang paling sering ditemukan dan disebabkan oleh perforasi atau nekrose infeksi transmural dari kelainan. Spontaneous bacterial peritonitis sbp is one of the prevalent conditions associated with liver cirrhosis and as cites increasing its mortality several folds. Peritonitis and abdominal sepsis differential diagnoses. Spontaneous bacterial peritonitis sbp is an infection of the ascitic fluid in patients with liver cirrhosis and portal hypertension 1. Ascites and spontaneous bacterial peritonitis schiffs diseases of. It is a major cause of the high rates of mortality. The colon contains a large number of bacteria, more than the number of cells in the entire human body. Look for wbc 250500 cellsmm 3 or neutrophil count 250 cellsmm 3.
Spontaneous bacterial peritonitis sbp is the infection of ascitic fluid in the absence of any intraabdominal, surgically treatable source of infection. The first page of the pdf of this article appears above. Spontaneous bacterial peritonitis sbp rebel em emergency. Peritonitis is an infection within the peritoneum, the supportive membrane lining that surrounds and protects the internal abdominal.
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