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. 2017 Oct 16:13:1409-1414.
doi: 10.2147/TCRM.S144262. eCollection 2017.

Spontaneous peritonitis in critically ill cirrhotic patients: a diagnostic algorithm for clinicians and future perspectives

Marco Fiore  1 , Alberto Enrico Maraolo  2 , Sebastiano Leone  3 , Ivan Gentile  2 , Arturo Cuomo  4 , Vincenzo Schiavone  5 , Sabrina Bimonte  4 , Maria Caterina Pace  1 , Marco Cascella  4
Affiliations

Spontaneous peritonitis in critically ill cirrhotic patients: a diagnostic algorithm for clinicians and future perspectives

Marco Fiore et al. Ther Clin Risk Manag. .

Abstract

Spontaneous peritonitis (SP) is the most common infection among decompensated end-stage liver disease patients. SP is the infection of ascitic fluid (neutrophil ascitic count ≥250/mL) without an alternative focus of abdominal infection. According to the causative agent, clinicians can make the diagnosis of spontaneous bacterial peritonitis or spontaneous fungal peritonitis. The mortality rate is very high, ranging from one-fifth of the patients with spontaneous bacterial peritonitis to four-fifths of the patients with spontaneous fungal peritonitis. An immediate and accurate diagnosis can improve the outcome in end-stage liver disease patients. The aim of this work is to provide physicians with a practical diagnostic guidance for SP diagnosis according to current evidence, in order to improve the management of cirrhotic patients with infected ascitic fluid.

Keywords: bacteriascites; cirrhosis; fungal ascites; spontaneous bacterial peritonitis; spontaneous fungal peritonitis.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The algorithm. Abbreviations: EAT, empiric antibiotic therapy; IDS, International Diagnostic Solutions; PMN, polymorphonuclear.
See this image and copyright information in PMC

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