Spontaneous bacterial peritonitis (SBP)

Posted by e-Medical PPT Monday, September 6, 2010
Spontaneous bacterial peritonitis (SBP) is defined as an ascitic fluid infection without an evident intraabdominal surgically-treatable source.It occurs almost exclusively in people with portal hypertension,usually as a result of cirrhosis of the liver and also occur in patients with nephrotic syndrome.SBP is thought to result from a combination of factors inherent in cirrhosis and ascites, such as prolonged bacteremia secondary to compromised host defenses, intrahepatic shunting of colonized blood, and defective bactericidal activity within the ascitic fluid.
Symptoms of Spontaneous bacterial peritonitis are fevers, chills, nausea, vomiting, abdominal tenderness and general malaise.Patients may complain of abdominal pain and worsening ascites.Hepatic encephalopathy may be the only manifestation of SBP;in the absence of a clear precipitant for the encephalopathy.
The diagnosis of SBP requires paracentesis.
After confirmation of SBP, patients need hospital admission for intravenous antibiotics (most often cefotaxime 2g IV for at least 5 days or ceftriaxone 2g IV ). They will often also receive intravenous albumin. A repeat paracentesis in 48 hours is sometimes performed to ensure control of infection.

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