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Spontaneous bacterial peritonitis: an update

J A Gilbert1, P S Kamath

  • 1Division of Gastroenterology, Mayo Clinic Rochester, MN 55905.

Mayo Clinic Proceedings
|April 1, 1995
PubMed
Summary
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Spontaneous bacterial peritonitis (SBP) primarily affects patients with end-stage liver disease. Early diagnosis and treatment are crucial, but SBP often recurs, necessitating liver transplantation assessment.

Area of Science:

  • Gastroenterology
  • Hepatology
  • Infectious Diseases

Background:

  • Spontaneous bacterial peritonitis (SBP) is a serious infection in patients with ascites, predominantly those with end-stage liver disease.
  • It often arises from the translocation of enteric organisms, mainly gram-negative bacilli.

Purpose of the Study:

  • To provide a comprehensive overview of spontaneous bacterial peritonitis (SBP).
  • To detail current diagnostic criteria, treatment strategies, and preventive measures for SBP.

Main Methods:

  • A literature review focusing on the etiopathogenesis, diagnosis, treatment, and prevention of SBP.
  • Discussion of various studies and presentation of diagnostic and therapeutic algorithms.

Main Results:

Related Experiment Videos

  • SBP typically occurs in patients with advanced liver disease and ascites without secondary causes.
  • Subtle clinical signs often mask SBP; ascitic fluid polymorphonuclear leukocyte count is key for diagnosis.
  • Third-generation cephalosporins (e.g., cefotaxime) are first-line treatment, while quinolones (e.g., norfloxacin) aid prevention of recurrence.

Conclusions:

  • Despite advances, SBP exhibits high recurrence rates and mortality.
  • Prompt diagnosis and effective antimicrobial therapy are vital.
  • Liver transplantation should be considered for patients with SBP.