[Incidence of spontaneous bacterial peritonitis in cirrhotic patients with ascites. A two-year prospective study]

The prevalence of spontaneous bacterial peritonitis in patients with decompensated liver cirrhosis admitted to our unit during last two years was studied. Criteria of spontaneous bacterial peritonitis were positive bacteriology and greater than 250/mm3 polymorphonuclear leukocyte count. 84 examinations in 50 patients were made. Spontaneous bacterial peritonitis was diagnosed in 4 cases. E. coli, Klebsiella pneumoniae, alpha haemolyzing Streptococcus were isolated from ascitic fluid in positive cases. Three patients died despite of therapy, one patient recovered. Bacterascites (positive bacteriology without increased polymorphonuclear leukocyte count) was detected in two cases. Culture-negatív neutrocytic ascites (greater than 250/mm3 polymorphonuclear leukocyte count without positive bacteriology) was detected in four cases. The clinical picture of above-mentioned cases was symptomless. Low protein concentration of ascitic fluid (less than 10 g/l) predisposing to spontaneous bacterial peritonitis, was found in 15% of cases. Incidence of spontaneous bacterial peritonitis and equivocal states found by us was similar to the data given by the literature: 15-20%. Because of the high mortality rate and frequent symptomless course in cirrhotics, importance of diagnostic paracentesis is stressed.