ROLE OF SERUM AND ASCETIC FLUID HIGH SENSITIVITY C-REACTIVE PROTIEN IN DIAGNOSIS OF SPONTANOUS BACTERIAL PERITONITIS
IhabAbdelazizAbdelmotyMesbah;
Abstract
This study was carried out on 60 patients in the Department of internal medicine at AIN SHAMS University Teaching Hospital.
The patients were divided into two groups:
Group one: 30 patients of established cirrhosis with ascites had no existing evidence or past history of SBP.
Group Two:30 Patients with cirrhotic ascites who are admitted with SBP or developed SBP during hospital stay diagnosed by clinical and laboratory evaluations.
Patients with hepatocellular carcinoma, hepatorenal syndrome, diabetes mellitus, portal vein thrombosis or who had received antibiotics or diuretics one week prior to admission were excluded from this study.
The aim of this study to compare the level of serum CRP in cirrhotic patients with and without SBP monthly over a period of 3 months, to determine its possible protective role against acquiring infection.
All patients were subjected to full history taking, a thorough clinical examination, abdominal ultrasound, sonography an routine laboratory investigations.
About 20 ml of ascitic fluid was collected from each patient following standard aseptic technique. The ascitic fluid samples were subjected to bacteriological, cytological and routine chemical examination of ascitic fluid.
Ascitic serum CRP level was estimated at time of diagnosis. Over a period of 3 months, follow up paracentesis and CRP and serum CRP estimation in ascitic fluid was done monthly.
The two studied groups were comparable as regards age and gender with no significance between them.
SBP development is influenced to a greater extent by the degree of liver disease being predominant in patients with class C (73.33%) according to Child-Pugh classification than those patients with class B (26.7%).
Only 66.67% of patients who had or developed SBP have positive ascetic fluid culture while the remaining (33.33%) are categorized as CNNA.
The most common organisms isolated were gram negative mainly E. Coli in 50% of cases, Klebsiella in 30% of cases and the remaining were gram positive organisms.
The biochemical analysis of ascitic fluid content were comparable between two studied groups with significant reduction on A.F. albumin in patients with SBP and a significant increase of A.F. neutrophilic count and LDH values in the same group.
The patients were divided into two groups:
Group one: 30 patients of established cirrhosis with ascites had no existing evidence or past history of SBP.
Group Two:30 Patients with cirrhotic ascites who are admitted with SBP or developed SBP during hospital stay diagnosed by clinical and laboratory evaluations.
Patients with hepatocellular carcinoma, hepatorenal syndrome, diabetes mellitus, portal vein thrombosis or who had received antibiotics or diuretics one week prior to admission were excluded from this study.
The aim of this study to compare the level of serum CRP in cirrhotic patients with and without SBP monthly over a period of 3 months, to determine its possible protective role against acquiring infection.
All patients were subjected to full history taking, a thorough clinical examination, abdominal ultrasound, sonography an routine laboratory investigations.
About 20 ml of ascitic fluid was collected from each patient following standard aseptic technique. The ascitic fluid samples were subjected to bacteriological, cytological and routine chemical examination of ascitic fluid.
Ascitic serum CRP level was estimated at time of diagnosis. Over a period of 3 months, follow up paracentesis and CRP and serum CRP estimation in ascitic fluid was done monthly.
The two studied groups were comparable as regards age and gender with no significance between them.
SBP development is influenced to a greater extent by the degree of liver disease being predominant in patients with class C (73.33%) according to Child-Pugh classification than those patients with class B (26.7%).
Only 66.67% of patients who had or developed SBP have positive ascetic fluid culture while the remaining (33.33%) are categorized as CNNA.
The most common organisms isolated were gram negative mainly E. Coli in 50% of cases, Klebsiella in 30% of cases and the remaining were gram positive organisms.
The biochemical analysis of ascitic fluid content were comparable between two studied groups with significant reduction on A.F. albumin in patients with SBP and a significant increase of A.F. neutrophilic count and LDH values in the same group.
Other data
| Title | ROLE OF SERUM AND ASCETIC FLUID HIGH SENSITIVITY C-REACTIVE PROTIEN IN DIAGNOSIS OF SPONTANOUS BACTERIAL PERITONITIS | Other Titles | دور بروتين سى المتفاعل شديد الحساسية بالدم وبالسائل البريتونى فى تشخيص الإلتهاب البريتونى البكتيرى التلقائى | Authors | IhabAbdelazizAbdelmotyMesbah | Issue Date | 2014 |
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