Spontaneous Bacterial Peritonitis in Asymptomatic Patients with Decompansated Liver Disease: Risk Factors and Relation to Highly Sensitive C-Reactive Protein

Abstract

Liver cirrhosis and ascites are common problems among Egyptians. The cause of chronic liver disease is multi factorial including schistosomiasis and-or viral hepatitis. Spontaneous bacterial peritonitis (SBP) is defined as a monomicrobial infection of ascitic fluid in the absence of a contagious source of infection Spontaneous bacterial peritonitis (SBP) is a potentially life-threatening complication in patients with cirrhosis. According to the consensus of the International Ascites Club, diagnosis of SPB is based on ascitic fluid polymorph nuclear leukocyte (PMN)count ≥ 250mm³ by diagnostic paracentesis, and exclusion of secondary peritonitis .If ascitic fluid cultures were positive and neutrophil count was ≥ 250 mm³, such patients were diagnosed as having culture positive neutrocytic ascites. If ascitic fluid cultures were negative in the presence of neutrocytic ascites, these patients were characterized as having culture negative neutrocytic ascites (CNNA).Patients with positive cultures on ascitic fluid but without neutrocytic ascites were classified as having bacterascites. This study aimed to assess the prevalence and risk factors of SBP in asymptomatic patients with decompensated liver disease and the reliability of C- reactive protein and highly sensitive C -reactive protein as acute phase reactants in prediction of spontaneous bacterial peritonitis in asymptomatic patients with decompensated liver disease. In order to fulfill our aim 80 patients with chronic liver disease complicated by ascites and without symptoms and signs for SBP were studied for the risk factors and the prevalence of SBP and the relation between CRP, hsCRP and SBP.