Spontaneous bacterial peritonitis

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In conclusion, spontaneous bacterial peritonitis is a common complication of severe chronic liver disease that is associated with significant mortality. The evidence suggests that spontaneous bacteraemia is common in patients with cirrhosis, and when ascites with a low protein content is present, there is colonization and development of infection. The clinical features of SBP, fever, abdominal pain and tenderness, and development of encephalopathy, occur commenly, but they are neither pathognomonic nor invariable. The initial diagnosis of SBP is a clinical diagnosis resulting from the combination of the clinical syndrome and a ascitic fluid polymorphonuclear leukocyte count of >250/mm3. The diagnosis is confirmed with the finding of positive ascitic fluid cultures, generally for enteric organisms, the most common being Escherichia coli. Therapy should be commenced with cefotaxime initially, followed by an appropriate antibiotic, depending on the sensitities of the cultured organisms. One-third of patients do not respond to the infection and die as a concequence. A further 50% of patients with SBP die during their hospitalization, from complications of their severe chronic liver disease. In the future, earlier recognition of this syndrome and prevention of its recurrence may improve survival of patients with chronic liver disease.

Original languageEnglish (US)
Pages (from-to)438-448
Number of pages11
JournalJournal of Gastroenterology and Hepatology
Issue number4
Publication statusPublished - 1990


ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

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