scholarly journals Prevalence and Short Term Outcome of Spontaneous Bacterial Peritonitis of Known Chronic Liver Disease Patients

2015 ◽  
Vol 27 (1) ◽  
pp. 15-19 ◽  
Author(s):  
Mohammad Ismail ◽  
Mohammad Anisur Rahman
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Chronic Liver ◽  
Medical Emergency ◽  
P Value ◽  
Prospective Longitudinal Study ◽  
Bacterial Peritonitis ◽  
Prospective Longitudinal

Spontaneous bacterial peritonitis (SBP) is an infection of ascitic fluid occurring in the absence of a contiguous source of infection characterized by symptoms of fever, abdominal pain, rebound tenderness, encephalopathy. It may develope in hospitalized patients and mortality rate is significantly high. To determine the prevalence of SBP in chronic liver disease with ascites and to establish that SBP is the cause of higher mortality than non SBP, a prospective longitudinal study was carried out in patients attending in the inpatient Department of Gastroenterology of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorder Hospital(BIRDEM), Bangabandhu Sheikh Mujib Medical University(BSMMU), Dhaka Medical College Hospital(DMCH), Dhaka from March 2010 to September 2010. Among the 60 patients the most common age group was the 46-55 years. In physical finding below average body build was found in 48 (80.0%) cases. Malnutrition was found in 48(80.0%) cases. Per abdominal finding liver was not palpable in 54 (90.0%) cases. Shifting dullness was found in 59 (98.3%) cases. Fluid thrill was detected in 57 (95.0%) cases. It was found that SBP were developed in 11(18.3%) cases and remaining 49(81.7%) case were non SBP, which were higher than SBP. Organism of culture of ascitic fluid in SBP patients (n=11) were E. coli and Pseudomoas spp found in 2(18.2%) cases, the rest 6(54.5%) cases shows no growth. Among 11 SBP patients improvement occurred in 5(45.5%) cases and the rest 6(54.5%) cases died p value <.001. SBP is medical emergency, prompt management and prophylactic antibiotics are essential to reduce mortality.Medicine Today 2015 Vol.27(1): 15-19

scholarly journals Evaluation of diagnostic accuracy of C-Reactive protein as a biomarker of spontaneous bacterial peritonitis in patients having decompensated chronic liver disease.

2021 ◽  
Vol 28 (10) ◽  
pp. 1438-1442
Author(s):  
Kapeel Raja ◽  
Rizwan Saeed Kiyani ◽  
Sadia Rehman ◽  
Abdul Rashid ◽  
Sanjay Kumar ◽  
...  
Keyword(s):  
Liver Disease ◽  
Diagnostic Accuracy ◽  
Chronic Liver Disease ◽  
Ascitic Fluid ◽  
Predictive Value ◽  
Spontaneous Bacterial Peritonitis ◽  
Chronic Liver ◽  
C Reactive Protein ◽  
Bacterial Peritonitis ◽  
Reactive Protein

Objective: The objective of this study was to evaluate the diagnostic accuracy of C Reactive Protein (CRP) in diagnosing spontaneous bacterial peritonitis (SBP) in patients with decompensated chronic liver disease. Study Design: Cross Sectional study. Setting: Department of Medicine Sheikh Khalifa Bin Zayed Hospital Rawalakot Azad Kashmir. Period:  Feb 2018 to Dec 2018. Material & Methods: One hundred subjects with decompensated liver disease were recruited in this study after fulfilling inclusion criteria. The patients’ medical record number, age and gender was recorded upon admission. Baseline investigations including complete blood count, urine examination and chest X ray were done. Abdominal ultrasound was performed for detecting the presence of ascitic fluid. SBP was diagnosed if > 250 mm3 neutrophils are detected in the ascitic fluid. Serum CRP was detected and reported in mg/L. Results: SBP was detected in 32.8% of the patients having decompensated chronic liver disease. CRP levels were > 29.5mg/L in 36% of the patients while in 64% patients the CRP levels were < 29.5mg/L. The sensitivity of CRP for the diagnosis of SBP was calculated as 83.61% while the specificity was calculated as 87.2%. A positive predictive value was estimated as 76.12% and a negative predictive value was 91.59% while the diagnostic accuracy was calculated as 86.02% from the given data. Conclusion: CRP is a reliable diagnostic biomarker for spontaneous bacterial peritonitis in subjects having complications of chronic liver disease.

scholarly journals The validity of Triggering Receptor Expressed on Myeloid Cells (TREM-1) in diagnosis of Spontaneous Bacterial Peritonitis in cirrhotic patients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
W Abdelmonsef ◽  
N A Abdelkader ◽  
G A Ismail ◽  
M M Elgaafary ◽  
Y A Abdelrazek
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Chronic Liver ◽  
Statistical Significant Difference ◽  
Bacterial Peritonitis ◽  
Significant Difference ◽  
Cirrhotic Patients ◽  
The Mean

Abstract Background Spontaneous bacterial peritonitis (SBP) is a serious complication in cirrhotic patients with ascites. Without early antibiotic treatment, this complication is associated with a 30-50% mortality rate. Recently we have evaluated the validity and utility of ascitic fluid triggering receptors expressed on myeloid cells-1 (TREM-1) levels for the diagnosis of SBP. Patients and Methods This was a Prospective case control study conducted on 60 patients with chronic liver disease and ascites divided into two group, group 1 (control) 30 patients without SBP and group 2 (SBP) 30 patients, admitted to the Tropical Medicine Department with ascites due to chronic liver disease. All patients were subjected to full history taking and clinical examination full laboratory investigations including complete blood picture liver and renal profiles, C reactive protein, viral markers, abdominal ultrasound, UGI endoscopy and ascitic fluid sampling for biochemical testing, total and differential cell count, microbiological culture and TREM-1 level. Results There was high statistical significant difference between the two groups in the base level of TREM-1 in which the mean was 1280 pg/ml (1136.9) with level range between (580---4500pg/ml) in SBP versus mean 129.9 pg/ml (51.9) with level range between (60-250pg/ml) in the control group. Also there was a statistical significant difference in the level of TREM-1 before and after treatment in the SBP patients in which the mean of TREM-1 before treatment was 1280.6 pg/ml (1136.9) with level range between (580-4500pg/ml) versus mean 376.2 pg/ml (78.4) and level range between (260-560 pg/ml) after the treatment. Conclusion our data indicate that the measurement of ascitic fluid TREM-1 is rapid, easy and valid test in the diagnosis and follow up of chronic liver disease patients with SBP.

scholarly journals Frequency of spontaneous bacterial peritonintis in chronic liver disease patients using proton pump inhibitors.

2020 ◽  
Vol 27 (03) ◽  
pp. 455-460
Author(s):  
Tahir Ullah Khan ◽  
Wali Khan ◽  
Sajjad Iqbal
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Spontaneous Bacterial Peritonitis ◽  
Chronic Liver ◽  
P Value ◽  
Exclusion Criteria ◽  
Bacterial Peritonitis ◽  
Study Setting

Objectives: To determine the frequency of spontaneous bacterial peritonitis (SBP) in chronic liver disease patients with ascites using proton pump inhibitors (PPI). Study Design: Prospective cohort study. Setting: Medicine Unit-II, Shalamar Hospital Lahore. Period: From 1st January to 30thJune 2017. Materials & Methods: A total of 380 patients enrolled in present study were divided into two groups; PPI group and non PPI group. Each group had 190 patients. We performed an extensive matching in both groups to minimize selection bias and SBP incidence was compared in both groups. Multivariate analysis was applied to sort out the causal relationship between PPI use and SBP. Results: Applying strict exclusion criteria, SBP incidence in chronic liver disease patients with ascites was found significantly high in PPI group than non-PPI group (12.63% vs. 6.84%, P Value 0.002). Moreover, a large no of patients (39.47%) were using PPI for inappropriate indications while acid peptic disease was the most common indication for its use (60.53%). Conclusion: Use of proton pump inhibitors in chronic liver disease patients with ascites significantly increases the risk of spontaneous bacterial peritonitis.

scholarly journals Carbohydrate 19.9 Antigen Serum Levels in Liver Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Gaetano Bertino ◽  
Annalisa Maria Ardiri ◽  
Giuseppe Stefano Calvagno ◽  
Giulia Malaguarnera ◽  
Donatella Interlandi ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Serum Levels ◽  
Chronic Viral Hepatitis ◽  
Chronic Liver ◽  
Neoplastic Disease ◽  
Prospective Longitudinal Study ◽  
Ca 19.9 ◽  
Prospective Longitudinal

Background.Carbohydrate 19.9 antigen (CA19.9) has been used in the diagnosis and followup of gastrointestinal tumours. The aim of this prospective longitudinal study was the evaluation of CA19.9 levels in patients with chronic hepatitis and hepatic cirrhosis hepatitis C virus and B virus correlated.Materials and Methods. 180 patients were enrolled, 116 with HCV-related chronic liver disease (48% chronic hepatitis, 52% cirrhosis) and 64 with HBV-related chronic liver disease (86% chronic hepatitis, 14% cirrhosis). Patients with high levels of CA19.9 underwent abdominal ecography, gastroendoscopy, colonoscopy, and abdominal CT scan.Results.51.7% of patients with HCV-related chronic liver disease and 48.4% of those with HBV-related chronic liver disease presented high levels of CA19.9. None was affected by pancreatic or intestinal neoplasia, cholestatic jaundice, or other diseases potentially able to induce Ca19.9 elevations. CA19.9 levels were elevated in 43.3% of HCV chronic hepatitis, in 56.3% of HCV cirrhosis, in 45.1% of HBV chronic hepatitis, and in 58% of HBV cirrhosis.Conclusions.CA19.9 commonly increases in the serum of patients with chronic viral hepatitis. Elevation of CA 19.9 is not specific for neoplastic disease and is related to the severity of fibrosis and to the viral aetiology of hepatitis.

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