Spontaneous Bacterial peritonitis - Neonatal Disorders

What is Spontaneous Bacterial Peritonitis?

Spontaneous bacterial peritonitis (SBP) is an infection of the peritoneal fluid that occurs without an evident source of infection. It is a serious complication, primarily seen in children with advanced liver disease or other conditions causing ascites.

What Causes SBP in Children?

SBP is typically caused by the translocation of gut bacteria into the peritoneal cavity. The most common pathogens responsible for SBP include Escherichia coli, Klebsiella pneumoniae, and Streptococcus pneumoniae. Children with compromised immune systems, particularly those with cirrhosis or nephrotic syndrome, are at a higher risk.

What are the Symptoms of SBP?

Symptoms of SBP can be subtle, especially in younger children. Common symptoms include fever, abdominal pain, vomiting, and diarrhea. In some cases, children may present with altered mental status or sepsis. It is crucial to have a high index of suspicion in at-risk populations to ensure timely diagnosis and treatment.

How is SBP Diagnosed?

Diagnosis of SBP is primarily based on the analysis of ascitic fluid obtained via paracentesis. The fluid is evaluated for the presence of polymorphonuclear leukocytes (PMNs). A PMN count of 250 cells/mm³ or higher is considered diagnostic of SBP. Additionally, culture of the ascitic fluid can help identify the causative organism, although cultures may sometimes be negative.

What are the Treatment Options?

Immediate initiation of antibiotic therapy is crucial upon diagnosis of SBP. Empirical therapy often includes a third-generation cephalosporin, such as cefotaxime. Once the causative organism is identified, antibiotic therapy can be adjusted accordingly. Supportive care, including intravenous fluids and management of complications, is also essential.

Can SBP be Prevented?

In children with high-risk conditions, primary and secondary prophylaxis with antibiotics may be indicated to prevent SBP. Agents such as norfloxacin or trimethoprim-sulfamethoxazole are commonly used. Additionally, managing the underlying condition, such as optimizing liver function or controlling ascites, is important in reducing the risk of SBP.

What is the Prognosis?

The prognosis of SBP largely depends on the underlying condition of the child and the promptness of treatment. Early diagnosis and appropriate management significantly improve outcomes. However, children with severe liver disease or other comorbidities may have a poorer prognosis and may require more intensive management or even liver transplantation.

Relevant Publications

Preoperative Hepatology and Primary Care Visits Improve Postoperative Outcomes in Patients with Cirrhosis Undergoing Surgery.

Issue Release: 2024

Diabetes mellitus and the risk of spontaneous bacterial peritonitis in patients with liver cirrhosis: a systematic review and meta-analysis.

Issue Release: 2024

Noninfectious Ascites Neutrophilia in a Patient With Polycythemia Vera.

Issue Release: 2024

Cost-effectiveness of albumin in the treatment of decompensated cirrhosis in resource-limited healthcare settings.

Issue Release: 2024

Just the facts: Evaluation and management of spontaneous bacterial peritonitis.

Issue Release: 2024

The impact of direct inoculation of ascites into blood culture bottles on ascites culture positivity.

Issue Release: 2024

Clinical characteristics and predictors of benign portal vein thrombosis in patients with liver cirrhosis: A retrospective single-center study.

Issue Release: 2024

Spontaneous Bacterial Peritonitis Due to Bacillus licheniformis in an Autosomal Dominant Polycystic Kidney Disease Patient on Peritoneal Dialysis: A Rare Presentation Linked to Avian Exposure.

Issue Release: 2024

Diagnostic model for spontaneous bacterial peritonitis in cirrhotic patients with ascites: a multicenter cohort study.

Issue Release: 2024

A case of fungal peritonitis in a patient with paramalignant ascites.

Issue Release: 2024

Impact of Hypoglycemia on Hospitalized Patients With Hepatocellular Carcinoma.

Issue Release: 2024

Proton Pump Inhibitors in Patients with Cirrhosis: Pharmacokinetics, Benefits and Drawbacks.

Issue Release: 2024

Global prevalence and characteristics of infections and clinical outcomes in hospitalised patients with cirrhosis: a prospective cohort study for the CLEARED Consortium.

Issue Release: 2024

The Use of Proton Pump Inhibitors in Patients with Liver Cirrhosis: Real Life Experience.

Issue Release: 2024

High Mortality With Non-O1/Non-O139 Bacteraemia in Patients With Cirrhosis.

Issue Release: 2024

Ascites fluid calprotectin level is highly accurate in diagnosing spontaneous bacterial peritonitis: a preliminary proof of concept prospective study.

Issue Release: 2024

Identification of in ascites in the context of typhoidal tularaemia.

Issue Release: 2024

Diagnostic Paracentesis Within 1 Day Is Associated With Reduced Mortality and Length of Hospital Stay in Patients with Cirrhosis and Ascites.

Issue Release: 2024

Beta-blockers or Placebo for Primary Prophylaxis (BOPPP) of oesophageal varices: study protocol for a randomised controlled trial.

Issue Release: 2024

Spontaneous Bacterial Peritonitis: A Rare Complication of Pulmonary Arterial Hypertension.

Issue Release: 2024

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