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Spontaneous peritonitis in cirrhotic ascites

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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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References

  1. Conn HO, Fessel MJ: Spontaneous bacterial peritonitis in cirrhosis: variations on a theme. Medicine (Baltimore) 50:161–197, 1971

    Google Scholar 

  2. Caroli J, Platteborse R: Septicémie porto-cave. Cirrhosis du fore et septicémie à colibacille. Sem Hôp Paris 34:472–487, 1958

    Google Scholar 

  3. Kerr DNS, Pearson DT, Read AE: Infection of ascitic fluid in patients with hepatic cirrhosis. Gut 4:394–398, 1963

    Google Scholar 

  4. Conn HO: Spontaneous peritonitis and bacteremia in Laennec's cirrhosis caused by enteric organisms. Ann Intern Med 60:568–580, 1964

    PubMed  Google Scholar 

  5. Finlayson G, Roth HP: Acute abdominal emergencies in patients with cirrhosis. Arch Surg 88:947–953, 1964

    PubMed  Google Scholar 

  6. Paddock FK: The diagnostic significance of serum fluids in disease. N Engl J Med 223:1010–1015, 1940

    Google Scholar 

  7. Tisdale WA: Spontaneous colon bacillus bacteremia in Laennec's cirrhosis. Gastroenterology 40:141–147, 1961

    PubMed  Google Scholar 

  8. Whipple RJ, Harris FJ:E. coli septicemia in Laennec's cirrhosis of the liver. Ann Intern Med 33:462–466, 1950

    PubMed  Google Scholar 

  9. Epstein M, Calia FM, Gabuzda GP: Pneumococcal peritonitis in patients with post necrotic cirrhosis. N Engl J Med 278:69–73, 1968

    PubMed  Google Scholar 

  10. Duport HL, Spink WW: Infections due to gram-negative organisms: an analysis of 860 patients with bacteremia at the University of Minnesota Medical Center, 1958–1966. Medicine (Baltimore) 48:307–332, 1969

    Google Scholar 

  11. Jones EA, Coneley N, Sherlock S: Bacteremia in association with hepatocellular and hepatobiliary disease. Postgrad Med J 43 (March Suppl): 7–11, 1967

    PubMed  Google Scholar 

  12. Gorbach SL, Lal D, Levitan R: Intestinal microflora in Laennec's cirrhosis. J Clin Invest 49:36a, 1970

    Google Scholar 

  13. Coblentz A, Kelly KH, Fitzpatrick L, Bierman HR: Microbiologic studies of the portal and hepatic venous blood in man. Am J Med Sci 228: 298–300, 1954

    PubMed  Google Scholar 

  14. Taylor FL: Blood culture studies of portal vein. Arch Surg 72:889–892, 1956

    Google Scholar 

  15. Beeson PB, Brannon ES, Warren JV: Observations on the sites of removal of bacteria from the blood in patients with bacterial endocarditis. J Exp Med 81:9–23, 1945

    Google Scholar 

  16. Rutenburg AM, Sonneblick E, Koven I, Schweinburg F, Fine J: Comparative response of normal and cirrhotic rats to intravenously injected bacteria. Proc Soc Exp Biol Med 101:279–281, 1959

    PubMed  Google Scholar 

  17. McMeo AN, Andersen BR: “Defective chemotaxis” associated with a serum inhibitor in cirrhotic patients. N Engl J Med 286:735–740, 1972

    PubMed  Google Scholar 

  18. Schweinburg FB, Seligman AM, Fine J: Transmural migration of intestinal bacteria. A study based on the use of radioactiveE. coli. N Engl J Med 242:747–751, 1950

    PubMed  Google Scholar 

  19. Brayton RG, Stokes PE, Schwartz MS, Louria DB: Effect of alcohol and various diseases on leucocyte mobilization, phagocytosis, and intracellular bacterial killing. N Engl J Med 282:123–128, 1970

    PubMed  Google Scholar 

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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

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  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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