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What is ascites with SBP?
Spontaneous bacterial peritonitis (SBP) is the infection of ascitic fluid in the absence of any intra‐abdominal, surgically treatable source of infection. Despite timely diagnosis and treatment its reported incidence in ascitic patients varies between 7–30%. Ascitic paracentesis remains the chief diagnostic procedure.
Can SBP cause ascites?
Spontaneous bacterial peritonitis is an infection of abdominal fluid, called ascites, that does not come from an obvious place within the abdomen, such as a hole in the intestines or a collection of pus. The condition typically affects people with liver disease, who often develop ascites as their disease worsens.
What does it mean when ascites is refractory?
Refractory ascites is defined as ascites that does not recede or that recurs shortly after therapeutic paracentesis, despite sodium restriction and diuretic treatment. To date, there is no approved medical therapy specifically for refractory ascites.
Can you have SBP without ascites?
Spontaneous bacterial peritonitis (SBP) is defined as an ascitic fluid infection without an evident intra-abdominal surgically treatable source [1].
How do you treat SBP?
Any person with cirrhosis and ascites who has signs or symptoms concerning for SBP should be treated with antibiotic therapy regardless of ascitic fluid PMN count. Recommended therapy for SBP consists of intravenous cefotaxime 2 grams every 8 hours (or a similar third-generation cephalosporin) for a duration of 5 days.
What are the symptoms of SBP?
What are the signs and symptoms of spontaneous bacterial peritonitis (SBP)?
- Fever and chills (as many as 80% of patients)
- Abdominal pain or discomfort (found in as many as 70% of patients)
- Worsening or unexplained encephalopathy.
- Diarrhea.
- Ascites that does not improve following administration of diuretic medication.
Can tuberculosis cause ascites?
Tuberculosis is reported to be the cause of ascites in only 2% of patients; however ascites constitutes the most common form of presentation of tuberculous peritonitis (TBP).
What stage of cirrhosis does ascites occur?
Ascites is the main complication of cirrhosis,3 and the mean time period to its development is approximately 10 years. Ascites is a landmark in the progression into the decompensated phase of cirrhosis and is associated with a poor prognosis and quality of life; mortality is estimated to be 50% in 2 years.
How long can you live with refractory ascites?
In the absence of liver transplantation, a diagnosis of refractory ascites confers a median life expectancy of ≤6 months [3,4,5]. End-of-life care in patients with ESLD and refractory ascites has not been a research priority.
Can you get SBP without cirrhosis?
SBP occurs almost exclusively in the setting of cirrhosis and large-volume ascites. However, it may also be acute, as in fulminant hepatic failure; or subacute, as in alcoholic hepatitis.
How can you tell the difference between SBP and secondary peritonitis?
SBP is an acute ascites infection an ascitic fluid polymorphonuclear (PMN) cell count of ≥250 cells/mm3 both with or without a positive ascitic fluid bacterial culture. SBP can be differentiated from secondary bacterial peritonitis by the absence of a surgically treatable intra-abdominal source of infection.
When to use norfloxacin in patients with ascites?
In patients with cirrhosis and ascites, longterm use of norfloxacin (or trimethoprim/ sulfamethasoxazole) can be justified if the ascitic fluid protein <1.5 g/dL along with impaired renal function (creatinine ≥1.2, BUN ≥25 or serum Na ≤130) or liver failure (Child score ≥9 and bilirubin ≥3.
How is nsbb used in the treatment of cirrhosis?
Independent of hemodynamic response, NSBB treatment has also been shown to decrease intestinal permeability and bacterial translocation, and to prevent the development of spontaneous bacterial peritonitis (SBP), a common and ominous infection in patients with decompensated cirrhosis [ 7, 8, 9 ].
What does SBP stand for in medical terms?
Spontaneous bacterial peritonitis (SBP) is a term used to describe acute infection of ascites, an abnormal accumulation of fluid in the abdomen without a distinct or identifiable source of infection.
What is the survival rate for SBP patients?
Typically, patients who experience SBP have chronic liver disease with a Child-Pugh classification, which assesses the prognosis of liver disease, of C. This ranking involves a high to a maximum score of 10 to 15 points (on the Child-Pugh scale) and measures 1-year patient survival at 45% and 2-year survival at 35%.