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[Spontaneous bacterial peritonitis: studies of the incidence and clinical and laboratory chemical parameters]
E Höring1, S Kubin, U von Gaisberg
1Medizinische Klinik Krankenhaus Bad Cannstatt, Stuttgart.
Abstract:
In a prospective study on 151 patients with cirrhosis of the liver we found 9 episodes of spontaneous bacterial peritonitis (SBP) in 8 patients (5.3% of the whole population or 18% of the ascitic patients). There was a clear difference in WBC-count, polymorphonuclear cell count, LDH and lactate in the ascitic fluid between SBP and controls. Clinical symptoms were discrete. 6 of 8 patients had an advanced form of cirrhosis belonging to Child-grade C. Half of patients died. The clinical situation of the 4 survivors improved after antibiotic treatment. Ascitic analysis of WBC and PMC-count in combination with LDH and lactate may reveal SBP as the reason of fever or clinical impairment in cirrhotics.
Insights
Spontaneous bacterial peritonitis (SBP) affects 5.3% of cirrhosis patients. Ascitic fluid analysis aids in diagnosing SBP, guiding treatment for improved outcomes in liver disease patients.
Area of Science:
- Gastroenterology and Hepatology
- Infectious Diseases
Context:
- Cirrhosis of the liver is a significant health concern with various complications.
- Spontaneous bacterial peritonitis (SBP) is a serious infection in patients with cirrhosis and ascites.
Purpose:
- To investigate the incidence of SBP in cirrhosis patients.
- To identify diagnostic markers for SBP in ascitic fluid.
- To assess the clinical presentation, outcomes, and treatment response in SBP patients.
Summary:
- A prospective study identified 9 episodes of SBP in 8 out of 151 cirrhosis patients (5.3% overall, 18% of ascitic patients).
- Significant differences in ascitic fluid white blood cell (WBC) count, polymorphonuclear cell (PMC) count, lactate dehydrogenase (LDH), and lactate levels were observed between SBP patients and controls.
- Most SBP cases (6/8) occurred in patients with advanced cirrhosis (Child-grade C), and half of the patients died, although survivors showed improvement after antibiotic treatment.
Impact:
- Ascitic fluid analysis, particularly WBC and PMC counts combined with LDH and lactate levels, can effectively diagnose SBP in cirrhosis patients presenting with fever or clinical deterioration.
- Early diagnosis and appropriate antibiotic treatment are crucial for improving patient outcomes and survival rates in SBP.
- This study highlights the importance of vigilant monitoring and diagnostic paracentesis in ascitic cirrhosis patients to detect SBP promptly.