Tuberculous versus Spontaneous Bacterial Peritonitis in a Patient with Advanced Cirrhosis of Liver: Diagnostic Dilemma

2009 ◽  
Vol 104 ◽  
pp. S318
Author(s):  
Bryan Santiago ◽  
Kiran Goli ◽  
Delatre Lolo
Keyword(s):  
Spontaneous Bacterial Peritonitis ◽  
Diagnostic Dilemma ◽  
Bacterial Peritonitis ◽  
Advanced Cirrhosis ◽  
Cirrhosis Of Liver

scholarly journals Study on ascitic fluid protein level in cirrhotic patients with spontaneous bacterial peritonitis

2009 ◽  
Vol 35 (2) ◽  
pp. 41-43 ◽  
Author(s):  
M. Golam Mustafa ◽  
M. Ayub Al Mamun ◽  
A.K.M. Khorshed Alam
Keyword(s):  
Ascitic Fluid ◽  
Total Protein ◽  
Protein Level ◽  
Spontaneous Bacterial Peritonitis ◽  
Bacterial Peritonitis ◽  
Complement 3 ◽  
Advanced Cirrhosis ◽  
Cirrhotic Patients ◽  
Hepatic Synthesis

Complement 3 is an important component of ascitic fluid total protein, which offers local defence against infection of the ascitic fluid. Hepatic synthesis of complement 3 as well as other proteins and their concentrations in ascitic fluid is significantly reduced in patients with advanced cirrhosis. The level of protein in ascitic fluid in cirrhotic patients with spontaneous bacterial peritonitis was compared with that in patients without spontaneous bacterial peritonitis. Ascitic fluid protein level in spontaneous bacterial peritonitis (n=15) was 1.1 ± 0.3 g/dL whereas it was 1.5 ± 0.5 g/dL in patients without spontaneous bacterial peritonitis (n=15). In conclusion, this study suggests that, ascitic fluid protein level is significantly (p=0.008) reduced in cirrhotic patients who develop spontaneous bacterial peritonitis.Keywords: Ascitic fluid; Bacteria; Cirrhosis; PeritonitisOnline: 11 August 2009DOI: 10.3329/bmrcb.v35i2.3023Bangladesh Med Res Counc Bull 2009; 35: 41-43

scholarly journals SPONTANEOUS BACTERIAL PERITONITIS (SBP)

2018 ◽  
Vol 25 (05) ◽  
pp. 749-752
Author(s):  
Waseem Sarwar Malghani ◽  
Farooq Mohyud Din Chaudhary ◽  
Muhammad Ilyas ◽  
Asma Tameez Ud Din ◽  
Asim Tameez Ud Din
Keyword(s):  
Liver Cirrhosis ◽  
Spontaneous Bacterial Peritonitis ◽  
Sampling Period ◽  
College Hospital ◽  
Staph Aureus ◽  
Medical College ◽  
Bacterial Peritonitis ◽  
Male Patients ◽  
Cirrhosis Of Liver ◽  
Aseptic Conditions

Background: Spontaneous bacterial peritonitis (SBP) is a bacterial infectionwhich occurs in cirrhosis of liver complicated by ascites. To decrease the high in-hospitalmortality rate of 20 to 30%, rapid diagnosis and antibiotic treatment are essential. Objectives:To ascertain the frequency of causative organisms of SBP. Study Design: Descriptive study.Setting: Gastroenterology Department, Nishtar Medical College/Hospital, Multan using nonprobability, consecutive sampling. Period: Jan 2017 to July 2017. Methodology: The studyincluded 183 patients of liver cirrhosis having SBP. Under aseptic conditions, ascitic fluid tapwas done and sent for bacterial culture. Data was analyzed by computer program SPSS-18.Results: Of these 183 study cases, 103 (56.3%) were male patients while 80 (43.7%) werefemale patients. Mean age of our study cases was 51.73 ± 9.28 years. Mean duration ofdisease (liver cirrhosis) was 26.43 ± 12.32 months while mean duration of SBP was 4.51 ±1.21 days. More than half of cases (56.3%) of liver disease were caused by Chronic Hepatitis C,13.7% were due to Hepatitis B and 16.9% of patients were alcoholics. Among the study cases,E.coli was noted in 135 (73.8%), Staph. Aureus in 17.5% and Klebsiella was noted in 8.7%.Conclusion: Our study indicates that E.coli is the major organism causing SBP in patientshaving cirrhosis of liver followed by Staph. Aureus and Klebsiella.

scholarly journals Clinico-bacteriological profile of spontaneous bacterial peritonitis in cirrhosis of liver with ascites

2019 ◽  
Vol 7 (11) ◽  
pp. 4256
Author(s):  
Shewtank Goel ◽  
Pooja Tripathi Pandey ◽  
Abhay Kumar ◽  
Nidhish Kumar ◽  
Deval Kumar Arora ◽  
...  
Keyword(s):  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Tertiary Care ◽  
Coagulase Negative Staphylococcus ◽  
Bacterial Peritonitis ◽  
Rebound Tenderness ◽  
Fluid Analysis ◽  
Cirrhotic Patients ◽  
Cirrhosis Of Liver ◽  
Culture Negative

Background: A good and an effective empirical treatment of SBP is not possible unless bacteriological spectrum and their antibiogram is clear. This becomes more important in country like India due to high antibiotic resistance.  Authors aim was to assess the prevalence of SBP, clinical and microbiological profile of its variants, in patients with cirrhosis seeking care at a tertiary care teaching hospital.Methods: Patients of liver cirrhosis with ascites seeking care at study subject during January- December 2018 formed the study population. Diagnosis was based on clinical examination, biochemical investigation and ultrasonography. Diagnostic abdominal paracentesis was performed on subjects within 24 hours of admission. Ascitic fluid was aspirated. It was sent for microbiological examination.Results: Prevalence of SBP was 16.12%. Out of total ten subjects with Spontaneous Bacterial Peritonitis (SBP), six subjects were of Culture Negative Neutrocytic Ascites (CNNA). Thus most common (60%), variant of Spontaneous Bacterial Peritonitis (SBP) was Culture Negative Neutrocytic Ascites (CNNA). Prevalence of Mono-microbial Non-neutrocytic Bacterascites (MNBA) and Classic-Spontaneous Bacterial Peritonitis (C-SBP) was 20%.  Two subjects found positive for MNBA, Staphylococcus aureus and Acinitobacter spp. was detected in each patient. Klebseila pneumonia, Escherichia coli and Coagulase negative Staphylococcus were found in ascitic fluid culture of C-SBP. In clinical variants of SBP, 80% subject’s complaint about abdominal pain. Hepatic-encephalopathy and fever was seen in 7(70%) patients. Rebound tenderness was seen among 60%.Conclusions: Diagnostic paracentesis should be advised to all cirrhotic patients with ascites. Ascitic fluid analysis should be sent for better selection of antibiotics thus better outcome of cirrhotic patients.

scholarly journals Hepato-renal Syndrome: Etiopathogenesis, Diagnosis and Treatment

2014 ◽  
Vol 15 (2) ◽  
pp. 95-100
Author(s):  
Jelena Nešić ◽  
Nenad Zornić ◽  
Vesna Rosić ◽  
Dejan Petrović
Keyword(s):  
Spontaneous Bacterial Peritonitis ◽  
Hepatorenal Syndrome ◽  
Clinical Importance ◽  
Bacterial Peritonitis ◽  
Appropriate Treatment ◽  
Advanced Cirrhosis ◽  
Nephrotoxic Drugs ◽  
Inflammatory Drugs ◽  
One Year ◽  
Timely Treatment

ABSTRACTHepatorenal syndrome (HRS) involves reversible renal failure in patients with advanced cirrhosis or acute liver failure. The aim of the study was to determine the pathogenetic mechanisms of the development of hepatorenal syndrome and to emphasise the clinical importance of early detection and timely treatment of patients with this condition. Th e one-year incidence rate of hepatorenal syndrome in patients with liver cirrhosis is 18-20%. Th e risk factors for the development of hepatorenal syndrome include the following: spontaneous bacterial peritonitis, gastrointestinal bleeding, nephrotoxic drugs, diuretics, non-steroidal anti-inflammatory drugs, and hyponatraemia. The primary plan of treatment is a liver transplantation, while a secondary plan of treatment is the use of a vasoconstrictor in conjunction with albumin. Early diagnosis and prompt appropriate treatment can significantly reduce the mortality rate of patients with hepatorenal syndrome.

scholarly journals Study of etiology, clinical profile and predictive factors of spontaneous bacterial peritonitis in cirrhosis of liver

2017 ◽  
Vol 5 (6) ◽  
pp. 2326
Author(s):  
Juhi B. Kawale ◽  
Kavita J. Rawat
Keyword(s):  
Hepatic Encephalopathy ◽  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Strong Association ◽  
Tertiary Care ◽  
High Serum ◽  
Polymorphonuclear Leucocyte ◽  
Care Hospital ◽  
Bacterial Peritonitis ◽  
Cirrhosis Of Liver

Background: Spontaneous bacterial peritonitis (SBP) is one of the potentially lethal complication of liver cirrhosis and is defined as infected ascites in the absence of any recognizable secondary cause of infection. Majority of the SBP cases are caused by organism from the gastrointestinal tract mainly aerobic gram-negative organisms- Escherichia coli being the most common etiological agent.Methods: It was a prospective observational study done over a period of 1 year in a tertiary care hospital. 50 patients from medical and gastroenterology wards were included in the study. Patients above 12 year of age with diagnosed cirrhosis of liver and documented evidence of SBP were included. Pregnant females, patients who refused to give consent, patients with a documented evidence of intra-abdominal source of infection or patients with ascitis due to non-hepatic causes were excluded.Results: The high serum bilirubin and creatinine levels were associated with higher mortality rate. Hepatic encephalopathy is associated with worse outcome. The outcome of the patient in relation to the grades of ascitis, liver enzymes, prothrombin time, international normalised ratio (INR), Child pugh grades, ascitic fluid polymorphonuclear leucocyte count, ascitic fluid culture and blood culture were not statistically significant.Conclusions: A high index of suspicion should exist for SBP in patients with cirrhosis and ascitis. Serum creatinine and bilirubin levels are strong predictors of mortality. Hepatic encephalopathy has a strong association with mortality in patients with spontaneous bacterial peritonitis.

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