Spontaneous Bacterial Peritonitis

by Carlo Raj, MD

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    00:01 Spontaneous Bacterial Peritonitis I find that many students get this confused and they are exactly sure when to choose this as being the diagnosis.

    00:10 Let's take a look at first the risk factor for SBP.

    00:15 Recent gastrointestinal hemorrhage.

    00:18 Ascitic fluid less than 1 gram.

    00:21 In other words, there is Ascitis taking place. Therefore, Remember, the peritoneal cavity has not been compromised.

    00:28 There is every possibility that the fluid within the peritoneal cavity may then become infected.

    00:34 We call this Spontaneous Bacterial Peritonitis.

    00:38 The name pretty much tells you exactly what's going on with this risk factors.

    00:42 And there might be prior episodes of SBP - Spontaneous Bacterial Peritonitis.

    00:49 Microbiologically, the gram negative organisms will play a role 70% of the time if not greater. That is extremely concerning.

    00:57 You might have Streptococci the gram positive organisms.

    01:00 often times though however, you might find, polymicrobial infection therefore suggesting that the origin of the Spontaneous Bacterial Peritonitis might have been the bowel that then perforated.

    01:11 How? What if it was diverticular disease? which is extremely common in the U.S.

    01:17 Where diverticulosis, diverticulitis and with enough inflammation, a rapture, there's every possibility that it might result in Spontaneous Bacterial Peritonitis.

    01:30 Clinical presentation: Severe abdominal pain, fever, and perhaps encephalopathy if the issue took place and originated from the liver.

    01:40 Diagnosis: With ascitic fluid, in which you expect "Aperitonitis" you can expect your neutrophils to be quite high bedside inoculation of ascetic fluid into blood culture bottles increases your yield.

    01:57 There, that way, immediately you can tell as to whether not your patient is suffering from SBP.

    02:02 Something that you very much want to keep in mind, when the patient is suffering from ascites.

    02:07 Management, third generation cephalosporin.

    02:10 Albumin because the liver might be depressed.

    02:13 And phrophylaxis with Co-trimoxazole, sulfamethoxazole and Trimethoprim.

    About the Lecture

    The lecture Spontaneous Bacterial Peritonitis by Carlo Raj, MD is from the course Cirrhosis – Liver Diseases.

    Included Quiz Questions

    1. Ascitic fluid of protein < 1 g
    2. Ascitic fluid of protein > 1 g
    3. Ascitic fluid of glucose
    4. SAAG of ascitic fluid < 1.1
    5. SAAG of ascitic fluid > 1.1
    1. Moraxella catarrhalis
    2. Gram-negative bacteria
    3. Streptococcus
    4. Staphylococcus
    5. Polymicrobial infection

    Author of lecture Spontaneous Bacterial Peritonitis

     Carlo Raj, MD

    Carlo Raj, MD

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