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 767: Transaminitis and Rhabdomyolysis

Podcast 767: Transaminitis and Rhabdomyolysis

Contributor: Sam Killian, MD Educational Pearls: Transaminitis refers to the elevation of transaminases, enzymes of the liver (AST and ALT) Elevation of ALT is relatively specific to the liver, but A...

28 Mars 20223min

Podcast 766: Truth about Tramadol

Podcast 766: Truth about Tramadol

Contributor: Aaron Lessen, MD Educational Pearls: Tramadol is often thought of as a mild-opiate to use for analgesia, but it is a more complicated drug Tramadol needs to be metabolized into an effect...

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Podcast 765: Phenobarbital for Alcohol Withdrawal

Podcast 765: Phenobarbital for Alcohol Withdrawal

Contributor: Aaron Lessen, MD Educational Pearls: Retrospective cohort study looked at return rate of discharged patients after receiving either phenobarbital or benzodiazepines or both in the ED for...

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Podcast 764: Myth or Merit: Beta-Blockers for Cocaine Chest Pain

Podcast 764: Myth or Merit: Beta-Blockers for Cocaine Chest Pain

Contributor: Chris Holmes, MD Educational Pearls: Many are taught that patients with cocaine chest pain should not receive beta-blockers due to unopposed alpha agonism, but is this true? 363 consecut...

15 Mars 20223min

Podcast 763: Sternoclavicular Infection

Podcast 763: Sternoclavicular Infection

Contributor: Aaron Lessen, MD Educational Pearls: Septic arthritis can occur at any joint, including the sternoclavicular joint Sternoclavicular joint infections comprise 1% of all bone and joint inf...

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UnfilterED #14: Patricia Hernandez, MSIV and Leyanet Gonzalez, MSIV

UnfilterED #14: Patricia Hernandez, MSIV and Leyanet Gonzalez, MSIV

Tune in for a double feature with our Equity, Diversity and Inclusion Award winners from this fall as Nick asks them about their backgrounds, what brought them into medicine and Emergency Medicine spe...

9 Mars 202250min

Podcast 762: Endocarditis

Podcast 762: Endocarditis

Contributor: Jared Scott, MD Educational Pearls: Variability of organisms in infecting the myocardial valves Duke Criteria for Infective Endocarditis includes three categories that can be used to def...

8 Mars 20225min

Podcast 761: Peritonsillar Abscess: To Stab or Not to Stab?

Podcast 761: Peritonsillar Abscess: To Stab or Not to Stab?

Contributor: Jared Scott, MD Educational Pearls: Often present with complaints of sore throat, pain with swallowing, difficulty swallowing, voice change, and possible fever Retrospective study from 2...

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