Peritonitis additional info

Question 1

a key differential for abdominal pain and fever in patients with cirrhosis and portal hypertension?

Answer 1

Spontaneous bacterial peritonitis

Question 2

what is Secondary peritonitis

Answer 2

Secondary peritonitis is a condition which occurs when a patient develops an peritoneal infection secondary to another infection, such as diverticulitis or appendicitis. This is less frequently associated with ascites and a more obvious focus of infection would be noted.

Question 3

Spontaneous bacterial peritonitis: most common organism found on ascitic fluid?

Answer 3

E.coli

The most common causative organisms of SBP are gram-negative enteric bacteria. E coli is by far the most common followed by Klebsiella. The most common gram-positive organism causing SBP is Streptococcus pneumoniae followed by Streptococcus viridans and Staphylococcus.Typically only one single organism is involved in the development of SBP.

Question 4

SBP non specific symptoms

Answer 4

nausea and vomiting, abdominal tenderness, fever and general malaise, hepatic encepalopathy

Question 5

Who should prophylactic antibiotics be given to and which type?

Answer 5

Prophylactic antibiotics (cephalosporins and quinolones) should be given to patients who have ascites and meet certain criteria.

NICE recommend: ‘Offer prophylactic oral ciprofloxacin or norfloxacin for people with cirrhosis and ascites with an ascitic protein of 15 g/litre or less until the ascites has resolved’

Question 6

abdominal pain and fever in patients with ascites?

Answer 6

spontaneous bacterial peritonitis (SBP.

Question 7

RISK FACTORS FOR SBP

Answer 7

seen in patients with ascites secondary to liver cirrhosis.
- ALCOHOLIC