PBE Flashcards

1
Q

Definição

A

Infecção da ascite que surge na ausência de uma fonte contígua de contaminação

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2
Q

Fisiopatologia

A

Translocacao bacteriana

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3
Q

Etiologia

A

E.coli

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4
Q

PBE em crianças

A

Pneumococo

Associada a sd nefrotica (lesao minima)

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5
Q

Clínica

A

Febre + dor abdominal + encefalopatia

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6
Q

Quando suspeitar de PBE?

A

Piora do quadro clínico de paciente com ascite

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7
Q

Diagnóstico

A

> 250 PMN (neutrofilos)
+
Cultura positiva

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8
Q

Bacterascite nao neutrofilica

A

Cultura positiva
<250 PMN
Fase precoce
Cd: tratar sintomaticos

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9
Q

Ascite neutrofilica

A
PMN > 250
Cultura negativa 
Hemorragia, carcinomatose, tb, pancreatite
Cd: sempre recebe atb
Obs.: vc ja esta tratando
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10
Q

Principal ddx da PBE

A

PBS

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11
Q

Dois ou mais criterios que indicam PBS e provavel laparotomia

A
Prot total > 1,0
Glicose < 50
LDH elevada
CEA > 5
FA > 240
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12
Q

Tratamento da PBE

A

CefaLosporina de 3ª : Cefotaxima 2g IV 8/8h

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13
Q

Se não responder a cefotaxima

A

Procurar PBS

Incluir Metronidazol

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14
Q

Profilaxia primaria aguda

A

Pcts cirroticos apos hemorragia gastrointestinal
7 dias de atb: ceftriaxone, Bactrim ou norfloxacino
Iniciar norfloxacino qnd pct melhorar um pouco

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15
Q

Profilaxia primaria cronica

A

Iniciar se ptn total em ascite <= 1,5

Norfloxacino 40mg ate morrer

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16
Q

Profilaxia secundária

A

Todos os pcts que desenvolveram PBE

Norfloxacino ate morrer

17
Q

Profilaxia para SHR

A

Albumina 1,5g/kg no 1º dia e 1g/kg no 3º dia