Template:Diagnosis of SBP
Diagnosis of SBP via Ascitic Fluid Analysis
Standard Evaluation
- Paracentesis results supporting a diagnosis of SBP:
- 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[2]
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.
- ↑ Hoefs JC "Increase in ascites white blood cell and protein concentrations during diuresis in patients with chronic liver disease."Hepatology. 1981;1(3):249. PMID 7286905