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Spontaneous bacterial peritonitis caused by S. paratyphi A
The Journal of the Association of Physicians of India
|June 28, 2014
Summary
Spontaneous bacterial peritonitis (SBP) from S. paratyphi A is rare, especially in chronic liver disease patients. This case highlights SBP diagnosis and successful cefotaxime treatment in a patient with portal hypertension.
Area of Science:
- Infectious Diseases
- Hepatology
- Microbiology
Background:
- Spontaneous bacterial peritonitis (SBP) is a serious infection in patients with advanced liver disease and ascites.
- While common pathogens include Escherichia coli and Klebsiella pneumoniae, SBP caused by Salmonella paratyphi A is infrequently reported.
Observation:
- A patient with chronic liver disease and portal hypertension presented with symptoms suggestive of SBP.
- Ascitic fluid analysis revealed a neutrophil count exceeding 250/mm3, confirming the diagnosis of SBP.
Findings:
- Cultures of the ascitic fluid identified Salmonella paratyphi A as the causative agent.
- The patient received intravenous cefotaxime, a third-generation cephalosporin antibiotic.
- Clinical improvement was observed following the administration of cefotaxime.
Implications:
- This case underscores the importance of considering less common pathogens like S. paratyphi A in SBP diagnosis.
- Early laboratory investigation of ascitic fluid is crucial for accurate diagnosis and targeted therapy.
- Intravenous cefotaxime demonstrates efficacy in treating SBP caused by S. paratyphi A in patients with underlying liver conditions.
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