A patient with long-standing alcoholic cirrhosis presents to your ER with altered mental status…or fever….or abdominal pain… or new onset ascites. He reports this is his normal skin color. He also reports his wife’s hair is always 4 feet tall and blue and his children’s hair color is the exact same color as their skin.
What is the likely diagnosis?
Spontaneous Bacterial Peritonitis
‘
How do you diagnose this?
Diagnostic Paracentesis with PMN >250
What is treatment for this disease?
Antibiotics of course – usually a 3rd generation cephalosporin like ceftriaxone or cefotaxime.
By Dr. Andrew Grock and Dr. Sally Bogoch.
References
Tintinalli’s 7th ed
uptodate.com
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andygrock
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1 Comment
Ian deSouza · May 5, 2015 at 12:01 pm
Beyond the “bored review”, there is SOME evidence to support the use of albumin infusion in order to prevent the complication of renal impairment. An interesting but somewhat underpowered study:
Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis. N Engl J Med. 1999 Aug 5;341(6):403-9. PMID: 10432325