spontaneous bacterial peritonitis


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spontaneous bacterial peritonitis

Spontaneous peritonitis Critical care A severe acute infection of the peritoneum that accompanies end-stage liver disease and ascites Agents E coli, Klebsiella spp, S pneumoniae, Enterococcus faecalis Clinical Abdominal pain, ascites, chills, encephalopathy, fever, rebound tenderness Lab Ascitic fluid has > 500–often 10,000+ PMNs/mm3, protein > 1.0 g/dL, monomicrobials; 40% are culture-negative Risk factors Cirrhosis, nephrotic syndrome, peptic ulcer disease, appendicitis, diverticulitis Treatment 3rd-generation cephalosporins–eg, cefotaxime, + IV albumin Mortality 30-40%, less if treated early, worse if accompanied by signs of poor liver function–eg, upper GI bleeding, BR > 8 mg/dL, serum albumin < 2.5 g/dL, hepatic encephalopathy, hepatorenal syndrome. See Peritonitis.
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Medication list review [] Is patient receiving medications as ordered [] Deep vein thrombosis prophylaxis--subcutaneous heparin or pneumatic boots if contraindicated (elevated INR unrelated to Coumadin is not a contraindication) [] Beta-blocker for known varices or documented contraindications to beta- blockers Spontaneous bacterial peritonitis (SBP) [] Prophylaxis with either Cipro 500 mg once a day or Bactrim DS once a day for one of the following: 1.
Norfloxacin and cisapride combination decreases the incidence of spontaneous bacterial peritonitis in cirrhotic ascites.
High levels of tumor necrosis factor-[alpha] and interleukin-6 in the ascitic fluid of cirrhotic patients with spontaneous bacterial peritonitis.
Current management of the complications of cirrhosis and portal hypertension: Variceal hemorrhage, ascites, and spontaneous bacterial peritonitis.
2) Serious complications from cirrhosis, which may contribute to hospitalization and even death, include variceal bleeding, spontaneous bacterial peritonitis, hepatocellular carcinoma, hepatorenal syndrome, hepatic encephalopathy, and hepatopulmonary syndrome.
Pretransplant antimicrobial drug exposure also includes norfloxacin prophylaxis in patients with a history of spontaneous bacterial peritonitis.
Enteric microorganisms are the common cause of spontaneous bacterial peritonitis (SBP).
The most common bacterial infections in these patients are spontaneous bacterial peritonitis, urinary tract infection, and bacteremia.
Reports are also available for atypical presentations, including pneumonia after aspiration of seawater, septic arthritis, epiglottitis, spontaneous bacterial peritonitis, meningitis, endometritis, myositis, osteomyelitis, and corneal ulcer.
Spontaneous bacterial peritonitis due to Yersinia enterocolitica in secondary alcoholic hemochromatosis.
A diagnosis of spontaneous bacterial peritonitis associated with alcoholic liver cirrhosis was made, and the patient was treated with 2 g/day of ceftriaxone.
Patients with cirrhosis are prone to small bowel bacterial overgrowth, which has been shown to correlate with increased rates of infection, particularly spontaneous bacterial peritonitis (SBP).

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