Spontaneous bacterial peritonitis

Spontaneous bacterial peritonitis
SpecialtyGastroenterology Edit this on Wikidata

Spontaneous bacterial peritonitis (SBP) is the development of a bacterial infection in the peritoneum, despite the absence of an obvious source for the infection.[1] It is specifically an infection of the ascitic fluid – an increased volume of peritoneal fluid.[2] Ascites is most commonly a complication of cirrhosis of the liver.[1] It can also occur in patients with nephrotic syndrome.[3][4] SBP has a high mortality rate.[5]

The diagnosis of SBP requires paracentesis, a sampling of the peritoneal fluid taken from the peritoneal cavity.[6] If the fluid contains large numbers of white blood cells known as neutrophils (>250 cells/μL), infection is confirmed and antibiotics will be given, without waiting for culture results.[7] In addition to antibiotics, infusions of albumin are usually administered.[7]

Other life-threatening complications such as kidney malfunction and increased liver insufficiency can be triggered by spontaneous bacterial peritonitis.[8][9] 30% of SBP patients develop kidney malfunction, one of the strongest predictors for mortality. Where there are signs of this development albumin infusion will also be given.[10]

Spontaneous fungal peritonitis (SFP) can also occur and this can sometimes accompany a bacterial infection.[11]

  1. ^ a b Lata J, Stiburek O, Kopacova M (November 2009). "Spontaneous bacterial peritonitis: a severe complication of liver cirrhosis". World J. Gastroenterol. 15 (44): 5505–10. doi:10.3748/wjg.15.5505. PMC 2785051. PMID 19938187.
  2. ^ Alaniz, C; Regal, RE (April 2009). "Spontaneous bacterial peritonitis: a review of treatment options". Pharmacy and Therapeutics. 34 (4): 204–10. PMC 2697093. PMID 19561863.
  3. ^ Hingorani SR, Weiss NS, Watkins SL (August 2002). "Predictors of peritonitis in children with nephrotic syndrome". Pediatr. Nephrol. 17 (8): 678–82. doi:10.1007/s00467-002-0890-6. PMID 12185481. S2CID 8399366.
  4. ^ Teo, S; Walker, A; Steer, A (December 2013). "Spontaneous bacterial peritonitis as a presenting feature of nephrotic syndrome". Journal of Paediatrics and Child Health (Review). 49 (12): 1069–71. doi:10.1111/jpc.12389. PMID 24118585. S2CID 13181267.
  5. ^ MacIntosh, T (1 March 2018). "Emergency Management of Spontaneous Bacterial Peritonitis - A Clinical Review". Cureus. 10 (3): e2253. doi:10.7759/cureus.2253. PMC 5929973. PMID 29721399.
  6. ^ Rimola A, García-Tsao G, Navasa M, et al. (January 2000). "Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. International Ascites Club". J. Hepatol. 32 (1): 142–53. doi:10.1016/S0168-8278(00)80201-9. PMID 10673079.
  7. ^ a b Dever, JB; Sheikh, MY (June 2015). "Review article: spontaneous bacterial peritonitis--bacteriology, diagnosis, treatment, risk factors and prevention". Alimentary Pharmacology & Therapeutics (Review). 41 (11): 1116–31. doi:10.1111/apt.13172. PMID 25819304. S2CID 25620132.
  8. ^ Fernández, J; Bauer, TM; Navasa, M; Rodés, J (December 2000). "Diagnosis, treatment and prevention of spontaneous bacterial peritonitis". Baillière's Best Practice & Research. Clinical Gastroenterology. 14 (6): 975–990. doi:10.1053/bega.2000.0142. PMID 11139350.
  9. ^ Fukui, H; Kawaratani, H; Kaji, K; Takaya, H; Yoshiji, H (2018). "Management of refractory cirrhotic ascites: challenges and solutions". Hepatic Medicine: Evidence and Research. 10: 55–71. doi:10.2147/HMER.S136578. PMC 6039068. PMID 30013405.
  10. ^ Cite error: The named reference AithalMoore was invoked but never defined (see the help page).
  11. ^ Shizuma, T (27 February 2018). "Spontaneous bacterial and fungal peritonitis in patients with liver cirrhosis: A literature review". World Journal of Hepatology. 10 (2): 254–266. doi:10.4254/wjh.v10.i2.254. PMC 5838444. PMID 29527261.