Posted in
Volume 16 -
Number 3
MOHAMMAD RAMZAN RAJPUT, MUZAFAR ALI SHAIKH, ABDUL RAHIM SOLANGI, KOKAB SHAHAB, ASLAM RIND, SALEEM RIND,
Abstract | Full Text PDF
BACKGROUND: Spontaneous Bacterial Peritonitis (SBP) is the common and fatal complication of cirrhotic patient with ascites and is defined as, “presence of WBC count of 500/cubic mm or more or Neutrophil count of 250 /cubic mm or more in ascitic fluid with mono microbial positive culture, in the absence of an intra abdominal sources of infection”.
PATIENTS & METHODS: This prospective and observational study was conducted at Medical Ward-1 (Liaquat University of Medical & Health Sciences Jamshoro, Sindh)/ Hyderabad from 01st December 2008 to 30th November 2009. An established cases of liver cirrhosis with ascites having signs & symptoms of SBP were included & those proved to be with secondary peritonitis due to appendicitis, intestinal obstruction or perforation or trauma & patients with history of antibiotic therapy during past 10 days, all were excluded from the study.
RESULTS: Two hundred six cases of cirrhosis underwent ascitic fluid analysis, 112 were Male and 94 were Female, with M:F sex ratio 1.2:1. Mean age was between 20-60 Years. SBP was found in 36 (17.5%) patients by counting chamber method (i.e.; PMN > 250 /cubic mm) & SBP was found in 32 (15.5%) patient with 4-grade colorimeter Reagent strip method ( i.e.; grade - 3 positive ). Statistical comparative analysis was carried out between PMN count in ascitic fluid by counting chamber and 4-grade scale colorimetric reagent strip & efficacy of reagent strip for the diagnosis of SBP was evaluated by determining Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value & Accuracy as; 88.9%, 98.7%, 76.1%, 96.2% & 91.3% and M : F ratio was 2:1 respectively.
CONCLUSION: Early diagnosis & treatment can decrease mortality and morbidity of SBP, hence rapid bedside testing method by use of Reagent Strips is one of the best & rapid diagnostic tool for SBP at bedside.
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