[Spontaneous bacterial peritonitis: occurrence in chronic liver disease patients in Recife]

A prospective research was made on spontaneous bacterial peritonitis (SBP) in chronic liver disease patients presenting with ascites. Forty clinical cases, of 37 patients, were analysed. All subjects were submitted to clinical and laboratory evaluation and diagnostic paracentesis, and the material was obtained for biochemical dosages, pH determination, cytology and bacterial cultures. Thirty cases of sterile ascites and 10 of SBP (25%) were detected. In 5 (50%) with SBP, the clinical findings were characteristic, with fever, abdominal pain and rebound tenderness. In 2 patients (20%) the presentation was atypical, without the complete triad described above. Finally in 3 (30%) SBP was silent, without any suggestive clinical manifestations of infection. In 7 cases (70%) cultures were positives; Streptococcus pneumoniae (3 cases), Streptococcus pyogenes, Staphylococcus negative coagulase, Staphylococcus aureus and Klebsiella pneumoniae (one case each). In 7 (70%) SBP cases, the patients were admitted already infected in the hospital. Lethality in the SBP group was 30% and in the sterile ascites was 13.3%. We concluded that SBP is a frequent cause of morbid-lethality in patients with ascites and chronic hepatopathy, presenting itself often in a typical clinical manifestations.