Vol. 4, Issue 6, Part E (2018)

Background and Objective: Liver cirrhosis and ascites patients frequently experience the serious consequence of spontaneous bacterial peritonitis (SBP), which greatly increases the risk of mortality and morbidity. Finding out how common SBP is and what the clinical and laboratory characteristics are in cirrhotic individuals with ascites was the driving force behind this research.

Material and Methods: A prospective observational study was performed on 60 patients diagnosed with liver cirrhosis and ascites, who were hospitalized to the Department of Microbiology at Velammal Medical Hospital and Research Institute in Anuppanadi, Madurai, Tamil Nadu, India, from May 2017 to April 2018. Diagnostic paracentesis was conducted on all patients under sterile conditions, and the ascitic fluid was tested for cell count, albumin, total protein, culture, and sensitivity. SBP was diagnosed when the polymorphonuclear leukocyte (PMN) count in ascitic fluid was ≥250 cells/mm³, regardless of culture results. Clinical characteristics, hematological, and biochemical markers were documented and examined.

Results: The diagnosis of SBP was made in 18 out of 60 individuals (30%). Fever was the most prevalent clinical presentation (72.2%), followed by altered sensorium, abdominal pain, and other gastrointestinal symptoms. Those with SBP had far higher ascitic PMN counts and serum bilirubin levels than those without SBP, according to laboratory results. Out of the 18 instances of SBP, 8 (44.4%) showed culture positive, with Escherichia coli being the bacteria most commonly isolated. Signs of renal failure, hypoalbuminemia, and an extended prothrombin time were strongly linked to SBP.

Conclusion: Cirrhotic individuals with ascites often experience SBP, which can be a significant consequence. Timely diagnosis and management depend on early diagnostic paracentesis and the identification of clinical and laboratory indicators. It is suggested that all cirrhotic patients with ascites have routine screening for SBP, regardless of whether or not they experience symptoms.