A spontaneous bacterial peritonitis (SBP) is an inflammation of ascites fluid with no obvious source of ignition. Manifestations include fever, malaise and symptoms of ascites and deterioration of liver failure. The diagnosis is made by examining ascites fluid. Treatment is with cefotaxime or another antibiotic.

A spontaneous bacterial peritonitis (SBP) is an inflammation of ascites fluid with no obvious source of ignition. Manifestations include fever, malaise and symptoms of ascites and deterioration of liver failure. The diagnosis is made by examining ascites fluid. Treatment is with cefotaxime or another antibiotic.

See also liver structure and function and evaluation of the patient with liver disease.) A spontaneous bacterial peritonitis (SBP) is an inflammation of ascites fluid with no obvious source of ignition. Manifestations include fever, malaise and symptoms of ascites and deterioration of liver failure. The diagnosis is made by examining ascites fluid. Treatment is with cefotaxime or another antibiotic. Spontaneous bacterial peritonitis is particularly common in cirrhotic ascites. It can have serious consequences and lead to death. The most common bacteria causing a spontaneous bacterial peritonitis, are gram-negative Escherichia coli and Klebsiella pneumoniae and Gram-positive Streptococcus pneumoniae; usually only one pathogen is involved. Symptoms and complaints The patients have symptoms and signs of ascites. Discomfort is usually available; typically it is diffuse, constant and mild to moderate pronounced. Symptoms of spontaneous bacterial peritonitis may be fever, malaise, encephalopathy, worsening hepatic function and an inexplicable general clinical deterioration. There are peritoneal symptoms (eg. As plump, taut tummy), but they can withdraw in the presence of ascitic fluid. Diagnostics Diagnostic puncture The clinical diagnosis of spontaneous bacterial peritonitis can be difficult, the diagnosis requires a strong suspicion and a generous indication for performing a diagnostic paracentesis incl. Creating a culture. If you give the ascites fluid before incubation in a blood culture medium, increasing the sensitivity of the culture by about 70%. Number of polymorphonuclear neutrophils> 250 cells / mm is a diagnostic sign of spontaneous bacterial peritonitis. Blood cultures are also indicated. Because the spontaneous bacterial peritonitis is caused usually by a single species of pathogen, includes the presence of a mixed culture most likely indicates a perforation or a contaminated sample. Therapy cefotaxime or another antibiotic If a spontaneous bacterial peritonitis was diagnositziert is an antibiotic such as cefotaxime 2 g i.v. daily every recommended 4-8 hours (depending on the Gram stain and the result of the culture) for at least five days until the ascites fluid contains <250 PMN / ul. The antibiotics increases the chance of survival. Most quinolones (such. As norfloxacin 400 mg po 1 times a day) is recommended. Because the spontaneous bacterial peritonitis recur in 70% of patients within one year, received prophylactic antibiotics is indicated. Antibiotic prophylaxis in patients with variceal bleeding reduces the risk of spontaneous bacterial Peritoniti.

Health Life Media Team

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