Guidelines
Spontaneous Bacterial Peritonitis

Spontaneous Bacterial Peritonitis

Background

  • Ascitic fluid infection without an evident intra-abdominal surgically treatable source

  • Typically occurs in patients with cirrhosis and ascites with signs and symptoms such as fever, abdominal pain, or altered mental status

  • Secondary bacterial peritonitis (e.g., perforated viscus) should be ruled out either clinically, radiographically or by ascitic fluid analysis before the diagnosis of spontaneous bacterial peritonitis is made
  • Laboratory criteria for secondary bacterial peritonitis includes at least 2 of the below in ascitic fluid:
    • Total protein >10g/L
    • Glucose <2.8mmol/L
    • LDH > the upper limit of normal for serum
  • Cultures positive for polymicrobial infection or gram stain showing many different bacteria would suggest gut perforation
  • These patients require an urgent assessment for a surgical cause of abdominal infection

Microbiology

Additional Information