Template:Diagnosis of SBP

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
    • Protein < 1, Glucose > 50 (otherwise concern for secondary bacterial peritonitis)

For bloody tap, subtract 1 WBC for every 250 RBC

If on Peritoneal Dialysis

SBP if:

  • >100 total WBCs OR >50% neutrophils

If on Nightly APD

SBP if:

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