What is liver SBP?

Spontaneous bacterial peritonitis (SBP) is infection of ascitic fluid without an apparent source. Manifestations may include fever, malaise, and symptoms of ascites and worsening hepatic failure. Diagnosis is by examination of ascitic fluid. Treatment is with cefotaxime or another antibiotic.

What is SBP in cirrhosis?

Spontaneous bacterial peritonitis (SBP) should be suspected in patients with cirrhosis who develop signs or symptoms such as fever, abdominal pain, altered mental status, abdominal tenderness, or hypotension (table 1).

What is SBP in medicine?

Spontaneous bacterial peritonitis (SBP) is present when this tissue becomes infected and there is no clear cause.

Can you have SBP without cirrhosis?

SBP almost always occurs in patients with cirrhosis and large-volume ascites. Table I summarizes possible clinical presentations for SBP; however, approximately 13% of patients will have no sign or symptom of infection.

What causes bacterial infection of the liver?

The most common microbes responsible for liver infection are Gram-negative enteric and pneumococci. Risk factors for bacterial infection include decompensated alcoholic liver disease, fulminant hepatic failure, gastrointestinal bleeding, invasive procedures and impaired immune system.

How does cirrhosis lead to SBP?

The dysfunction of PMNs and the low levels of complement, both by decreasing in liver production associated to increased consumption as an acute phase response, are commonly observed in cirrhosis and seem to contribute to the conversion of ascitic fluid colonization into SBP (Runyon et al 1985; Guarner et al 1995; …

What does SBP mean?

Spontaneous bacterial peritonitis (SBP) is an acute bacterial infection of ascitic fluid. In addition, spontaneous bacterial peritonitis can occur as a complication of any disease state that produces the clinical syndrome of ascites, such as heart failure and Budd-Chiari syndrome.

What are the symptoms of SBP?

Presenting signs and symptoms can include fever, changes in mental status, abdominal tenderness, gastrointestinal (GI) bleeding, chills, nausea, or vomiting. In one study, fever (68%), mental status alterations (61%), and abdominal tenderness (46%) were the most frequent observations in patients with SBP.

How is SBP treated?

Any person with cirrhosis and ascites who has signs or symptoms concerning for SBP should be treated with antibiotic therapy regardless of ascitic fluid PMN count. Recommended therapy for SBP consists of intravenous cefotaxime 2 grams every 8 hours (or a similar third-generation cephalosporin) for a duration of 5 days.

How serious is SBP?

SBP is a serious complication in patients with cirrhosis with high mortality rates (20–40%).

What is the white blood cell count for SBP?

Polymorphonuclear leukocyte (PMN) count of > 250 cells/mcL (0.25 x 10 9 /L) is diagnostic of SBP. The PMN count is the total number of white blood cells in the ascites by the percentage of neutrophils. Blood cultures are also indicated.

What are the signs and symptoms of SBP?

Patients have symptoms and signs of ascites . Discomfort is usually present; it typically is diffuse, constant, and mild to moderate in severity. Signs of SBP may include fever, malaise, encephalopathy, worsening hepatic failure, and unexplained clinical deterioration.

What are the functions of bile in the liver?

Bile Production: Bile is a fluid that is critical to the digestion and absorption of fats in the small intestine. Filters Blood: All the blood leaving the stomach and intestines passes through the liver, which removes toxins, byproducts, and other harmful substances. Regulates Amino Acids: The production of proteins depend on amino acids.

How are blood cultures used to diagnose SBP?

Polymorphonuclear leukocyte (PMNs) count of > 250 cells/mcL (0.25 x 10 9 /L) is diagnostic of SBP. Blood cultures are also indicated. Because SBP usually results from a single organism, finding mixed flora on culture suggests a perforated abdominal viscus or contaminated specimen.