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 700: Analgesics for Acute Musculoskeletal Pain

Podcast 700: Analgesics for Acute Musculoskeletal Pain

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Podcast 699: Pediatric Fingernail Avulsions

Podcast 699: Pediatric Fingernail Avulsions

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Podcast 698: Empathy, Burnout, and Patient Satisfaction

Podcast 698: Empathy, Burnout, and Patient Satisfaction

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Podcast 697: Kounis Syndrome

Podcast 697: Kounis Syndrome

Contributor: Aaron Lessen, MD Educational Pearls: Kounis syndrome is an allergic acute coronary syndrome Triggers include medications (antibiotics), insect bites, or other common allergens Believed t...

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Podcast 696: ST Elevation and Differential Diagnoses

Podcast 696: ST Elevation and Differential Diagnoses

Contributor: Peter Bakes, MD Educational Pearls: ST elevation clinical guidelines for myocardial infarction include: 2.5 mm elevation for males 2 mm elevation in males >40 in V2 and V3 1.5 mm elev...

21 Heinä 20214min

Podcast 695: Einstein and Cellophane

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Educational Pearls: Albert Einstein had chronic abdominal pain as a middle-aged man Dr. Rudolph Nissen, founder of the Nissen fundoplication, performed exploratory surgery for this pain and found an ...

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