Template:Diagnosis of SBP: Difference between revisions
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**Bacteria on [[gram stain]] (single type) | **Bacteria on [[gram stain]] (single type) | ||
**SAAG > 1.1 | **SAAG > 1.1 | ||
***Diagnostic of portal hypertension with 97% accuracy<ref>Runyon BA, Montano AA, Akriviadis EA, et al. The serum-ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascites. Ann Intern Med 1992; 117:215.</ref> | |||
***SBP rarely develops in patients without portal hypertension | |||
**Protein < 1, Glucose > 50 (otherwise concern for secondary bacterial peritonitis) | **Protein < 1, Glucose > 50 (otherwise concern for secondary bacterial peritonitis) | ||
Revision as of 06:51, 2 November 2015
Diagnosis of SBP via Ascitic Fluid Analysis
Standard Evaluation
- Paracentesis results supporting a diagnosis of SBP:
- Total WBC >500
- Absolute neutrophil count (PMNs) > 250
- Bacteria on gram stain (single type)
- SAAG > 1.1
- Diagnostic of portal hypertension with 97% accuracy[1]
- SBP rarely develops in patients without portal hypertension
- Protein < 1, Glucose > 50 (otherwise concern for secondary bacterial peritonitis)
For bloody tap, subtract 1 WBC for every 250 RBC
If on Peritoneal Dialysis (CAPD)
SBP if:
- >100 total WBCs OR >50% neutrophils
If on Nightly APD
SBP if:
- >50% neutrophils
- Amylase (>100 suggestive of intra-abdominal process)
- ↑ Runyon BA, Montano AA, Akriviadis EA, et al. The serum-ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascites. Ann Intern Med 1992; 117:215.