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Spontaneous peritonitis in cirrhotic ascites

A decade of experience

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Abstract

In a ten-year retrospective study 15 cases of spontaneous bacterial peritonitis were identified. All patients had cirrhosis and ascites. Abdominal pain was present in all and abdominal tenderness in 11. Diagnosis was established by paracentesis with the finding of either an elevated ascitic fluid cell count (>300 WBC/mm3) in 13 cases or organisms and numerous neutrophiles on gram stain in 6 cases. On ascitic fluid cultureE coli was the most common organism isolated in 6 cases, klebsiella was isolated in 3 cases, andDiplococcus pneumoniae (D. pneumoniae) in 2 cases. Positive blood cultures were obtained in 60% of the cases. Three patients responded to therapy, including antibiotics, and survived to leave the hospital. No features unequivocally differentiated the survivors. The nonsurvivors died from complications of advanced liver disease including hepatic coma, hepatorenal syndrome, and esophageal variceal hemorrhage. Spontaneous bacterial peritonitis is a potentially treatable cause of deterioration in the patient with cirrhotic ascites. Because of its varied presentation it may escape recognition despite ease of diagnosis. Prompt recognition requires awareness of this entity.

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Authors and Affiliations

  1. Medical Services and Research Services of Wadsworth VA Hospital Center, 90073, Los Angeles, California

    Noel Curry MB, Richard W. McCallum MB &  Paul H. Guth MD

  2. Department of Medicine, UCLA School of Medicine, Los Angeles, California

    Noel Curry MB, Richard W. McCallum MB &  Paul H. Guth MD

Authors
  1. Noel Curry MB
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  2. Richard W. McCallum MB
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  3. Paul H. Guth MD
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Curry, N., McCallum, R.W. & Guth, P.H. Spontaneous peritonitis in cirrhotic ascites. Digest Dis Sci 19, 685–692 (1974). https://doi.org/10.1007/BF01844937

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