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 862: How to Apply a Painful Stimulus

Podcast 862: How to Apply a Painful Stimulus

Contributor: Travis Barlock MD Educational Pearls: When might you need to apply a painful stimulus in a medical setting? The main reason is to assess the patient's level of consciousness, such as wh...

31 Heinä 20232min

Podcast 861: Alcohol Withdrawal and Delirium Tremens

Podcast 861: Alcohol Withdrawal and Delirium Tremens

Contributor: Travis Barlock MD Educational Pearls: Alcohol binds the GABA receptor, which produces an inhibitory response, hence the "depressive" effects of ethanol beverages. Over time, alcohol d...

24 Heinä 20234min

Ukraine Brewtalk Featuring Dr. Dave Young

Ukraine Brewtalk Featuring Dr. Dave Young

Contributors: David Young MD, John Hesling MD, Travis Barlock MD, Jeffrey Olson Summary: In this episode, Dr. Travis Barlock and Jeffrey Olson meet in the studio to discuss several clips from the even...

21 Heinä 202338min

Podcast 860: Thyrotoxicosis

Podcast 860: Thyrotoxicosis

Contributor: Travis Barlock MD Educational Pearls: Clinical picture: A patient comes in with altered mental status, tachycardia, fever, elevated T4, and low TSH. What's the diagnosis?... Thyrotoxicosi...

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Podcast 859: Teamwork Really Makes the Dream Work

Podcast 859: Teamwork Really Makes the Dream Work

Contributor: Aaron Lessen MD Educational Pearls: 33 Medical residents and 91 nurses at Massachusetts General Hospital were randomized into two groups: Intervention group: 15 PGY-1 residents assig...

10 Heinä 20232min

Podcast 858: Whole Blood Pregnancy Test

Podcast 858: Whole Blood Pregnancy Test

Contributor: Meghan Hurley MD Educational Pearls: What do you do if you need a stat pregnancy test on an incapacitated patient? You can send a serum quantitative human chorionic gonadotropin (beta-H...

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Podcast 857: Alice in Wonderland Jeopardy

Podcast 857: Alice in Wonderland Jeopardy

Contributor: Chris Holmes MD Educational Pearls: "It's a poor sort of memory that only works backwards" - Transient Global Amnesia A syndrome with sudden retrograde memory loss in which patients ...

26 Kesä 20233min

Podcast 856: ED Errors and Counterstudy

Podcast 856: ED Errors and Counterstudy

Contributor: Nicholas Tsipis, MD Educational Pearls: What study was Dr. Tsipis talking about? In December of 2022, the Agency for Healthcare Research and Quality (AHRQ) put out a study titled "Diagn...

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