Bacterial Periotonitis

Question 1

What is the pathophysiology behind bacterial peritonitis

Answer 1

Common complication of ascites, spontaneous infection of ascitic fluid without intraabdominal source. Presumed translocation of gut flora to lymph nodes then to ascites fluid

Question 2

What are the most common infections in SBP

Answer 2

E. Coli, Strep, Staph, Enterococcus

Question 3

When is a perforated viscus assumed?

Answer 3

If ascites contains greater than 2 infectious organisms

Question 4

Symptoms of SBP

Answer 4

Fever, altered mental status, leukocytosis, abd pain,

Question 5

Treatment for SBP

Answer 5

Cefotaxime or ceftriaxone
Cipro (can’t use flourquinolones for prophylaxis)

Question 6

When is SBP prophylaxis indicated?

Answer 6

Ascites patient with GIB, once weekly ABX dosing

Question 7

What is a SAAG score and what is the interpretation of results

Answer 7

Serum Albumin: Ascites score
>1.1= portal htn
<1.1 malignant or infection

Question 8

What does elevated glucose in ascites fluid indicate

Answer 8

SBP