Spontaneous bacterial peritonitis

Spontaneous bacterial peritonitis
Specialty	Gastroenterology

Spontaneous bacterial peritonitis (SBP) is the development of a bacterial infection in the peritoneum, despite the absence of an obvious source for the infection.^[1] It is specifically an infection of the ascitic fluid – an increased volume of peritoneal fluid.^[2] Ascites is most commonly a complication of cirrhosis of the liver.^[1] It can also occur in patients with nephrotic syndrome.^[3][4] SBP has a high mortality rate.^[5]

The diagnosis of SBP requires paracentesis, a sampling of the peritoneal fluid taken from the peritoneal cavity.^[6] If the fluid contains large numbers of white blood cells known as neutrophils (>250 cells/μL), infection is confirmed and antibiotics will be given, without waiting for culture results.^[7] In addition to antibiotics, infusions of albumin are usually administered.^[7]

Other life-threatening complications such as kidney malfunction and increased liver insufficiency can be triggered by spontaneous bacterial peritonitis.^[8][9] 30% of SBP patients develop kidney malfunction, one of the strongest predictors for mortality. Where there are signs of this development albumin infusion will also be given.^[10]

Spontaneous fungal peritonitis (SFP) can also occur and this can sometimes accompany a bacterial infection.^[11]