Cirrhosis, ascites, fever, and abdominal tenderness
Can be subtle compared to secondary peritonitis
Paracentesis before starting antibiotics is ideal
Bacterial culture
Can consider fungal and mycobacterial
Inoculate a minimum of 2 blood culture bottles (1 aerobic & 1 anaerobic) with 10 mL of the ascitic fluid
Secondary bacterial peritonitis should be ruled out either clinically, radiographically or by ascitic fluid analysis before the diagnosis of SBP is made