SBP

Question 1

SBP

Answer 1

• bacterial infection of ascitic fluid
• e. coli, k. pneumonaie
• s. pneumoniae, s. aureus

Question 2

Treatment

Answer 2

can be active or prophylactic

Question 3

Diagnosis

Answer 3

-Fever, malaise, inc WBC, pain/tenderness in abdomen

Question 4

Paracentesis

Answer 4

• need absolute polymorhoucuated leukocyte count (>/= 250)

- WbC * PMN cells = absolute PLC

Question 5

Bacterial culture

Answer 5

• sometimes comes back negative

- treat even if negative

Question 6

Active infection treatment

Answer 6

• 3GC
• allergy: ciprofloxacin
• if identify bacterial-streamline therapy (within 48-72 hours of starting IV abx)
• 5 day treatment
• IV albumin 25% 1.5 g/kg on day 1, 1g/kg day 3
  
  • dec mortality

Question 7

Prophylaxis treatment

Answer 7

• 7 day course
• Indefinite SBP prophylaxis if they had previous SBP or low ascitic protein count with high SCr or BUN
• Ciprofloxacin 250-500 mg/daily or Bactrim DS daily