Spontaneous bacterial peritonitis (SBP) is a form of peritonitis that occurs in patients with cirrhosis. It occurs in 10-30% of hospitalized patients with ascites.

Sympatoms include fevers, chills, nausea, vomiting, abdominal tenderness and general malaise. Patients may complain of abdominal pain and worsening ascites.

Diagnosis necessitates paracentesis (needle drainage of the ascitic fluid) and laboratory confirmation of ascitic neutrophils > 250/mm³.

After confirmation of SBP, patients need hospital admission for intravenous antibiotics (most often cefotaxime or ceftriaxone). They will often also receive intravenous albumin. A repeat paracentesis in 48 hours is often required to ensure control of infection. Once patients have recovered from SBP, they require regular prophylactic antibiotics (e.g. Septra DS, Cipro, norfloxicin) as long as they still have ascites.

Gastroenterology