User:Mr. Ibrahem/Spontaneous bacterial peritonitis

Spontaneous bacterial peritonitis (SBP) is a bacterial infection of ascitic fluid in the abdomen without an obvious source. Symptoms generally include diffuse, mild to moderate abdominal pain that is constant in nature. Other symptoms may include fever or confusion. Complications may include kidney problems, further liver problems, and gastrointestinal bleeding.

Risk factors include liver cirrhosis, peritoneal carcinomatosis, heart failure, pancreatitis, and nephrotic syndrome. The most common organisms involved are gram-negative bacteria, such as E. coli. Diagnosis is by paracentesis, sampling of the peritoneal fluid. It is confirmed if the fluid contains large numbers of white blood cells known as neutrophils (>250 cells/µL).

Treatment is with antibiotics, without waiting for culture results. For those who develop infection in the community, generally ceftriaxone is used; while in those who develop infection in hospital piperacillin/tazobactam of a carbapenem is used. Infusions of albumin may also generally given. In those with cirrhosis who have a GI bleed, the use of antibiotics may prevent SBP.

SBP is present in about 15% of people admitted to hospital due to cirrhosis. It has a high risk of death, with 30% dead at one month and 60% dead at a year. The condition was first formally described by Harold O. Conn in 1964. Those at risk of SBP may also develop spontaneous fungal peritonitis (SFP).