Podcast 613: Spontaneous Bacterial Peritonitis

<p><strong> </strong></p> <p><strong>Contributor: Sam Killian, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;"><span style= "font-weight: 400;">Spontaneous bacterial peritonitis (SBP) is an infection of peritoneal fluid that typically occurs in cirrhotic patients</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Symptoms may include abdominal pain, fever, and/or altered mental status</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Paracentesis is diagnostic test of choice.</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Diagnostic criteria includes > 250 polymorphonuclear cells (PMNs) or a positive gram stain/culture</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Treatment is typically a 3</span><span style= "font-weight: 400;">rd</span> <span style= "font-weight: 400;">generation cephalosporin</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">·</span><span style="font-weight: 400;">30-40% of SBP patients will go into renal failure and SBP associated with sepsis has an ~80% mortality</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Dever JB, Sheikh MY.</span> <a href="https://pubmed.ncbi.nlm.nih.gov/25819304/"><span style= "font-weight: 400;">Review article: spontaneous bacterial peritonitis--bacteriology, diagnosis, treatment, risk factors and prevention</span></a><span style="font-weight: 400;">. Aliment Pharmacol Ther. 2015 Jun;41(11):1116-31. doi: 10.1111/apt.13172. Epub 2015 Mar 26. PMID: 25819304.</span></p> <p><span style="font-weight: 400;">MacIntosh T.</span> <a href= "https://pubmed.ncbi.nlm.nih.gov/29721399/"><span style= "font-weight: 400;">Emergency Management of Spontaneous Bacterial Peritonitis - A Clinical Review.</span></a> <span style= "font-weight: 400;">Cureus. 2018 Mar 1;10(3):e2253. doi: 10.7759/cureus.2253. PMID: 29721399; PMCID: PMC5929973.</span></p> <p> </p> <p><em><span st