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 746: Elderly Head Trauma on Anticoagulation

Podcast 746: Elderly Head Trauma on Anticoagulation

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Podcast 745: Nitrous-Induced B12 Deficiency

Contributor: Alicia Oberle, MD Educational Pearls: Nitrous oxide (N2O) can cause a vitamin B12 deficiency in patients after regular use N2O is used in procedural sedation but also as a popular recrea...

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Podcast 744: Glucagon for Beta Blocker Toxicity

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Podcast 743: Rust Rings

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Contributor: Jared Scott, MD Educational Pearls: A rust ring can occur after a metallic foreign body is left in the eye for a prolonged period of time Issues occur when the rust ring is left as it ca...

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Podcast 742: Pulse Check During CPR

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Contributor: Aaron Lessen, MD Educational Pearls: Pulse checks are necessary during CPR to check for return of spontaneous circulation (ROSC) Previous studies have shown that assessing ROSC with palp...

29 Dec 20213min

Podcast 741: Calcium for Cardiac Arrest

Podcast 741: Calcium for Cardiac Arrest

Contributor: Aaron Lessen, MD Educational Pearls: Study of nearly 400 patients evaluating giving calcium during cardiac arrest with the endpoint as return of spontaneous circulation (ROSC) Compared g...

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Podcast 740: Placenta Previa

Podcast 740: Placenta Previa

Contributor: Peter Bakes, MD Educational Pearls: High concern causes of third trimester vaginal bleeding include placenta previa, placental abruption, or vasa previa In placenta previa, the placenta ...

21 Dec 20213min

Podcast 739: Perceptions of Dress

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Contributor: Aaron Lessen, MD Educational Pearls: Study examined patient perceptions of providers wearing traditional white coats,  fleece coats and soft-shell jackets Found that white coats were see...

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