Criteria for Spontaneous Bacterial Peritonitis (SBP)

  • Paracentesis should be performed prior to start of antibiotics
  • analysis should include
    • cell count and differential
    • aerobic and anaerobic culture (performed using blood culture bottles)
    • Gram stain
    • chemistries (glucose, total protein, albumin, LDH, amylase)
  • presence of > 250 polymorphonuclear (PMN) cells/mm3 in fluid confirms diagnosis (when no intra-abdominal source is present)
  • positive culture not required for diagnosis but helps guide antibiotic selection

SBP can, by definition, only exist when portal hypertension exists!  Otherwise, it is simply infectious peritonitis.

– Points above from DynaMed, accessed October 2016

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