Spontaneous Bacterial Peritonitis In Patients With Liver Disease And Ascites As Seen At Kenyatta National Hospital.
Abstract
A prospective study was carried out on 100 consecutive
in patients with ascites and liver disease at Kenyatta
National Hospital (KNH) over a period of one year with a view
of finding cases of spontaneously infected ascites.
76 of the patients studied were males and 24 females with
mean ages of 46 and 43 years respectively.
10 patients (10%) (7 males and 3 females) were found to have
symptomatic spontaneOU5 bacterial peritonitis (SSBP) on
culture while 5 patients (5%) (3 males and 2 females) were
found to have positive ascitic fluid culture without clinical
signs and symptoms of peritonitis. 10 (10%) patients (9 males
and 1 female) were considered as possible cases of
spontaneous bacterial peritonitis on clinical grounds.
The mean fluid total white blood cell (WBC) count among
patients with asymptomatic sterile ascites (ASA) was 122.8
leukocytes/mm3 (standard deviation (s.d) 122.8 vmC/mm3) while
the mean for patients with culture positive SSBP was
179.6 WBC/mm3 (s.d 196.9 WBC/mm3). This difference was not
significant ( P> 0.20).
The mean ascitic fluid polymorph count among patients with
culture positive SSEP was 62% {s.d 33% of the total fluid WBC
count while the mean among patients with ASA was 29.7%
(s.d 23.1%)... The difference was significant at P < 0.001. There
was no patient among the ASA group with polymorph count greater
than 85% but 40% of patients with culture positive SSEP had
fluid polymorph count greater than 85% of total WEC count.
There was a high association of generalized abdominal
pain (100%), generalized abdominal tenderness (100%)
abnormal (low and high) body temperature (80%) and significant
ascitic fluid polymorphonuclear count with infected ascities.
Hypothermia, hepatic encephalopathy and presence of
enteric organisms on culture were factors associated with
poor outcome while hyperpyrexia was associated with a better
outcome.
Citation
Master of medicine,University of Nairobi,1985.Publisher
University of Nairobi medicine