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Related Experiment Videos

Spontaneous peritonitis: a reappraisal.

D Rimland, W L Hand

    The American Journal of the Medical Sciences
    |May 1, 1987
    PubMed
    Summary

    Spontaneous bacterial peritonitis in cirrhosis patients often lacks clear symptoms or diagnostic signs. This serious condition has a high mortality rate, with uncertain benefits from antibiotic treatment.

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    Area of Science:

    • Hepatology
    • Gastroenterology
    • Infectious Diseases

    Background:

    • Spontaneous bacterial peritonitis (SBP) is a common complication in patients with cirrhosis.
    • Accurate diagnosis and understanding the clinical spectrum of SBP are crucial for patient management.

    Purpose of the Study:

    • To delineate the characteristic symptoms, signs, and laboratory findings of spontaneous bacterial peritonitis in cirrhotic patients.
    • To compare these findings with a control group of cirrhotic patients without SBP.

    Main Methods:

    • A case-control study comparing 55 patients with SBP to 56 cirrhotic patients with negative ascitic fluid cultures.
    • Analysis of presenting symptoms, physical examination findings, laboratory results, and peritoneal fluid studies.

    Main Results:

    • Vomiting, fever, and severe gastrointestinal bleeding were significantly more prevalent in SBP cases.
    • No specific physical signs or laboratory tests reliably distinguished SBP cases from controls, except for elevated serum amylases in controls.
    • Peritoneal fluid cell counts and studies were often unhelpful in differentiating the groups.

    Conclusions:

    • Spontaneous bacterial peritonitis in cirrhotic patients often presents with non-specific symptoms and lacks distinct diagnostic markers.
    • The condition is associated with severe liver disease and carries a high mortality rate.
    • The impact of antibiotic therapy on prognosis remains uncertain based on this data.

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