Recognition of Spontaneous Bacterial Peritonitis in Cirrhosis with Ascites at PMC Hospital Nawabshah

Abstract

Objective: To determine the diagnosis and prevalence of spontaneous bacterial peritonitis in patients having cirrhosis of liver with ascites at tertiary care centre. Study Design: Cross sectional study. Place and Duration: Department of Medicine Peoples University of Medical &. health Science Nawabshah, from January 2013 to December 2015. Material and Methods: A total of 102 Cirrhotic patients with ascites admitted in all three medical units were studied. Diagnosis of cirrhosis was based on clinical features, laboratory findings and sonographic features. Patients who received antibiotic in preceding week were not included in the study. All patients underwent diagnostic paracentesis after admission. Ascitic fluid aspirated was sent for culture and for protein and cell count. Blood sample was sent for blood CP, LFT, PT, serum protein, and AG Ratio, Blood urea, Blood Sugar, and serum creatinine. Result: Out of those 102 patients studied 27(26.5%) patients were having SBP. 9(33.3%) patients Classical SBP, 17(63%) patients had culture negative neutrocytic ascites (CNNA) and 1(3.7%) patient developed nonomicrobial non-neutrocytic bacterascites (IVINB). In SBP patients abdominal pain, fever and encephalopathy were common. Among patients with SBP there were high serum bilirubin, prolonged prothrombin time and low ascitic fluid protein levels. Gram negative organisms were responsible for majority of cases of SBP. Conclusion: SBP is common complication of cirrhosis with ascites. Common clinical features are fever, abdominal pain and encephalopathy, and patients with total ascitic fluid protein at lower level are prone to develop SBP.