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What is Spontaneous bacterial Peritonitis is indicated by presence of _______ cell in ascitic fluid: and explain in detail?
Ans. (c) >250cells/cu.mm, Absolute PMNRef: Harrisons 19th/e pg. 846 & 1989; Sabiston's 20th/e pg.1078Spontaneous Bacterial Peritonitis (SBP)* SBP is a bacterial infection of ascitic fluid in the absence of an intra-abdominal source of infection, like perforation, abscess, acute pancreatitis, or cholecystitis.* More commonly seen in Low protein ascites in Cirrhosis, also seen in Nephrotic Syndrome and CCF.* Rare in patients who have high protein ascites like Carcinomatosis.* MC organism isolated are E. Coli and Klebsiella Pnuemonia. In children Group A Streptococcal and Staphylococcus aureus are causes.* C/F- Abdominal pain, fever and Leucocytosis.* Investigation: >250 Neutrophils/Cumm. Culture is Monomicrobial (Polymicrobial think of Secondary peritonitis).* Treatment of Choice- Third Generation Cephalosporins* In the Natural history of cirrhosis, if SBP occurs then 1 year and 2 year survival rates are 30% to 20%.