FREQUENCY OF SPONTANEOUS BACTERIAL PERITONITIS IN ASYMPTOMATIC PATIENTS WITH CIRRHOTIC ASCITES.

J Peop Univ Med Health Sci. 2025:15(3) 87-92. http://doi.org/10.46536/jpumhs/2025/15.03.662

Abstract

BACKGROUND: Spontaneous bacterial peritonitis (SBP) is a serious intra-abdominal infection that
commonly occurs in patients with cirrhotic ascites. Although it is usually seen in symptomatic patients, its
frequency in asymptomatic patients with cirrhotic ascites remains a topic of clinical interest, as it can go
unrecognized, thus increasing the risk of complications. OBJECTIVE: To identify the prevalence of
asymptomatic spontaneous bacterial peritonitis in patients with cirrhotic ascites. To proponent timely
detection and enhance clinical outcome via treatment. METHODOLOGY: A cross-sectional study was
conducted at Department of Medicine, Chandka Medical College Hospital, SMBBMU Larkana and 154
patients was enrolled in their first visit between 2024 and January 2025. Totally, 154 cirrhotic consecutive
patients aged 18–65, ascites patients but no spontaneous bacterial peritonitis symptoms were enrolled.
Following obtaining informed consent, the abdominal paracentesis was executed. Ascitic fluid was
studied for PMN count and culture result. Data was analyzed using SPSS version 25. RESULTS: Of 154
patients, 39 (25%) were found to have asymptomatic Spontaneous bacterial peritonitis by increased PMN
and positive fluid culture. Culture positivity was shown in 20(51%) with E. coli being most common
organism isolated (60%). Majority of the patient were in Child-Pugh B stage (63.6%). CONCLUSION:
Twenty-five percent of patients with ascites had asymptomatic Spontaneous bacterial peritonitis. Routine
diagnostic paracentesis should be done in all such patients whether symptoms is present or not so to
reduce morbidity & mortality.