Spontaneous Bacterial Peritonitis

Question 1

What is spontaneous bacterial peritonitis?

Answer 1

infection developing in the ascitic fluid and peritoneal lining without a clear source of infection (e.g., an ascitic drain or bowel perforation).

Question 2

Spontaneous bacterial peritonitis can be asymptomatic but what are some presenting features? (5)

Answer 2

• Fever
• Abdominal pain
• Deranged bloods (raised WBC, CRP, creatinine or metabolic acidosis)
• Ileus (reduced movement in the intestines)
• Hypotension

Question 3

What are the most common organisms that cause spontaneous bacterial peritonitis? (3)

Answer 3

E.coli
Klebsiella pneumonia
Gram +ve cocci e.g. staphylococcal + enterococcus

Question 4

What is the management of spontaneous bacterial peritonitis?

Answer 4

§ Taking a sample of ascitic fluid for culture before giving antibiotics
§ Intravenous broad-spectrum antibiotics according to local policies (e.g., piperacillin with tazobactam)