Template:Diagnosis of SBP

Diagnosis of SBP on Ascites Fluid Analysis

• Paracentesis results supporting a diagnosis of SBP:
  • Total WBC >500
  • Absolute neutrophil count (PMNs) > 250
  • Bacteria on gram stain (single type)
  • SAAG > 1.1
  • Protein < 1, Glucose > 50 (otherwise concern for secondary bacterial peritonitis)

For bloody tap, subtract 1 WBC for every 250 RBC

Consider Peritonitis (eg. perf appy, chole)

Any:

• >10,000 WBC
• Polymicrobial gm stain
• Total protein >1g/dL
• Glu <50
• Increased LDH

If on Peritoneal Dialysis

SBP if:

• >100WBC OR >50% NEUT

If on Nightly APD

SBP if:

• >50%NEUT
• Amylase (>100 suggestive of intra-abdominal process)