Revista Cubana de Medicina
On-line version ISSN 1561-302X
ASTENCIO RODRIGUEZ, Gloria et al. Spontaneous bacterial peritonitis in the patient presenting with hepatic cirrhosis. Rev cubana med [online]. 2010, vol.49, n.4, pp. 248-362. ISSN 1561-302X.
The spontaneous bacterial peritonitis (SBP) or spontaneous infection of ascetic fluid (SIAF) is one of the infections affecting frequently to patients presenting with cirrhosis, it may be present in other entities evolving with ascites like the nephrotic syndrome, peritoneal carcinomatosis and the heart failure. The aim of present paper was to assess the behavior of this complication in our environment. All the admitted decompensated patients presenting with hepatic cirrhosis and a moderate to severe ascites were studied in the Gastroenterology Service of "Hermanos Ameijeiras" Clinical Surgical Hospital from September, 2002 to February, 2007. From a sample of 70 patients, 26 of them fulfilled the diagnostic criteria of SBP (37.1 % of incidence). Within the spontaneous subtypes of peritonitis, 15 patients (57.6 %) had spontaneous bacterial peritonitis with positive culture, 7 (26.9 %) with negative culture and 4 (15.3 %) had symptomatic and poly-microbial bactero-ascites. There were not cases of spontaneous bacterial empyema. Abdominal pain occupied the first place among the clinical manifestations with 23 patients (88.4 %), followed by fever with 18 patients (69.2 %) and hepatic encephalopathy in the third place with 10 patients (38.4 %). There were not asymptomatic cases. The more frequent germs isolated in cultures were Escherichia coli in 10 patients (52.6 %), Klebsiella in 4 patients (21 %) and Pneumococcus in 3 patients (15.7 %).
Keywords : Peritonitis; spontaneous peritonitis; cirrhosis.