Spontaneous Bacterial Peritonitis

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Spontaneous Bacterial Peritonitis

• in association with Ascites

Epidemiology

• approximately 8% of cirrhotics with ascites

Pathology

• haematogenous spread

Organisms

• Escherichia coli
• Klebsiella
• Enterococci

Clinical Features

• ascites
• evidence of clinical deterioration
• pain / pyrexia may be absent

Investigations

• peritoneal aspiration
  • increased neutrophils implies need for immediate treatment

Treatment

• 3rd generation cephalosporin
  • cefotaxime / ceftazidime
• Liver Transplantation

Prognosis

• 50% mortality
• recurs in 70% patients

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