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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]
Spontaneous bacterial peritonitis (SBP) is a peculiar form of peritonitis occurring in the absence of an obvious source of contamination. It occurs in people with ascites, including children. Intra-peritoneal dialysis predisposes to peritoneal infection (sometimes named "primary peritonitis" in this context).
Primary peritonitis is the diffuse bacterial infection of the peritoneum while the integrity of the gastrointestinal tract is preserved (in cases of ascites); secondary peritonitis is the infection of peritoneum where the integrity of gastrointestinal tract is compromised; tertiary peritonitis is reinfection of peritoneum 48 hours after ...
Ascites (/ ə ˈ s aɪ t i z /; [5] Greek: ἀσκός, romanized: askos, meaning "bag" or "sac" [6]) is the abnormal build-up of fluid in the abdomen. [1] Technically, it is more than 25 ml of fluid in the peritoneal cavity, although volumes greater than one liter may occur. [4]
There is a difference in the organisms which cause secondary peritonitis compared to those that cause tertiary peritonitis and this can be referred to as a microbial shift. Some microfloral organisms have demonstrated multi-drug resistance highlighting the difficulty in treating the condition and so there is a poor prognosis.
Symptomatic relief may be provided by paracentesis, which may also diagnose spontaneous bacterial peritonitis (SBP) Gastrointestinal endoscopy may be used or patients with suspected peptic ulcer disease Helicobacter pylori testing may also be used; Trial medications may be beneficial for the diagnosis and treatment of:
A count of 250 neutrophils per ml or higher is considered diagnostic for spontaneous bacterial peritonitis. Cultures of the fluid can be taken, but the yield is approximately 40% (72–90% if blood culture bottles are used). Empiric antibiotics are typically started when spontaneous bacterial peritonitis is highly suspected.
The most common infection is peritonitis, followed by lung, skin, and urinary infections, meningoencephalitis and in the most serious cases septicaemia. The most notable of the causative organisms are Streptococcus pneumoniae and Haemophilus influenzae. Spontaneous bacterial peritonitis can develop where there is ascites present. This is a ...