Podcast 676: Spontaneous Bacterial Peritonitis

Podcast 676: Spontaneous Bacterial Peritonitis

Contributor: Sam Killian, MD

Educational Pearls:

  • Patients with cirrhosis and ascites are frequently evaluated for spontaneous bacterial peritonitis, an infection of the ascites fluid that is not from a surgically treated source
  • Fever, abdominal pain, and altered mental status should all raise clinical suspicion in a patient with ascites
  • Fluid from paracentesis may show increased WBCS (polys and neutrophils), high LDH, high amylase, and decreased glucose
  • Outcomes are very poor in these patients with 30-40% of these patients continue to renal failure with 60-80% in-hospital mortality
  • Typically treat with a third generation cephalosporin or ampicillin+gentamicin

References

Long B, Koyfman A. The emergency medicine evaluation and management of the patient with cirrhosis. Am J Emerg Med. 2018;36(4):689-698. doi:10.1016/j.ajem.2017.12.047

MacIntosh T. Emergency Management of Spontaneous Bacterial Peritonitis - A Clinical Review. Cureus. 2018;10(3):e2253. Published 2018 Mar 1. doi:10.7759/cureus.2253

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

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Podcast 875: A Pediatric Case of Myopericarditis

Podcast 875: A Pediatric Case of Myopericarditis

Contributor: Meghan Hurley MD Educational Pearls: Pericarditis is inflammation of the pericardial sac, which can arise from infectious or non-infectious etiologies Myocarditis is inflammation of t...

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Episode 874: Bradyarrhythmias

Episode 874: Bradyarrhythmias

Contributor: Dylan Luyten MD Educational Pearls: What is a Bradyarrhythmia? Also known as a bradyarrhythmia, it is an irregular heart rate that is also slow (below 60 beats per minute). What can c...

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Podcast 873: Intravesical Tranexamic Acid for Gross Hematuria

Podcast 873: Intravesical Tranexamic Acid for Gross Hematuria

Contributor: Aaron Lessen MD Educational Pearls: Tranexamic acid (TXA) is a common medication to achieve hemostasis in a variety of conditions Patients visiting the ED for gross hematuria (between...

16 Loka 20232min

Podcast 872: Preseptal and Orbital Cellulitis

Podcast 872: Preseptal and Orbital Cellulitis

Contributor: Meghan Hurley MD Educational Pearls: What is Cellulitis? A common and potentially serious bacterial skin infection. Caused by various types of bacteria, with Streptococcus and Staphyl...

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Mental Health Monthly #17: Mania

Mental Health Monthly #17: Mania

Contributors: Andrew White MD - Outpatient Psychiatrist; Fellowship Trained in Addiction Psychiatry; Denver Health Travis Barlock MD - Emergency Medicine Physician; Swedish Medical Center Summary In t...

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Podcast 871: Increased Intracranial Pressure and the Cushing Reflex

Podcast 871: Increased Intracranial Pressure and the Cushing Reflex

Contributor: Travis Barlock MD Education Pearls: The Cushing Reflex is a physiologic response to elevated intracranial pressure (ICP) Cushing's Triad: widened pulse pressure (systolic hypertensio...

2 Loka 20233min

On The Streets #15: Hydrofluoric Acid Case Review

On The Streets #15: Hydrofluoric Acid Case Review

Contributors: Kalen Abbott, MD - EM Physician and Medical Director for AirLife Denver Brendan Reiss - Flight Nurse AirLife Denver Matt Spoon - Flight Paramedic AirLife Denver Jordan Ourada - E...

29 Syys 202341min

Episode 870: Advanced Trauma Life Support (ATLS)

Episode 870: Advanced Trauma Life Support (ATLS)

Contributor: Meghan Hurley MD Educational Pearls: What is ATLS? Advanced Trauma Life Support (ATLS) is a systematic and comprehensive approach to the evaluation and management of trauma patients I...

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