Spontaneous bacterial peritonitis history and symptoms: Difference between revisions

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* Patients may complain of [[abdominal pain]] and worsening [[ascites]].  
* Patients may complain of [[abdominal pain]] and worsening [[ascites]].  
* It is important to emphasize, though, that [[hepatic encephalopathy]] may be the ''only'' manifestation of SBP, especially in people with [[cirrhosis]] and [[ascites]].
* It is important to emphasize, though, that [[hepatic encephalopathy]] may be the ''only'' manifestation of SBP, especially in people with [[cirrhosis]] and [[ascites]].
* The clinical presentation of SBP is highly variable and this condition may manifest as a relatively insidious colonization – without signs and symptoms or it can rapidly develop as a septic syndrome


==History==
==History==

Revision as of 20:50, 28 January 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2] Shivani Chaparala M.B.B.S [3]

Overview

  • The main manifestations of peritonitis are acute abdominal pain, tenderness, and guarding, which are exacerbated by moving the peritoneum, e.g. coughing, flexing the hips, or eliciting the Blumberg sign (a.k.a. rebound tenderness, meaning that pressing a hand on the abdomen elicits pain, but releasing the hand abruptly will aggravate the pain, as the peritoneum snaps back into place)
  • Symptoms include fevers, chills, nausea, vomiting, abdominal tenderness and general malaise.
  • Patients may complain of abdominal pain and worsening ascites.
  • It is important to emphasize, though, that hepatic encephalopathy may be the only manifestation of SBP, especially in people with cirrhosis and ascites.
  • The clinical presentation of SBP is highly variable and this condition may manifest as a relatively insidious colonization – without signs and symptoms or it can rapidly develop as a septic syndrome

History

A directed history should be obtained to ascertain the precipitant of this condition.

  • A detailed history has to be obtained regarding:
  • Previous episodes of SBP.
  • Onset of symptoms and their progression.
  • Presence of B-symptoms such as night-sweats, malaise, weight loss.
  • Immune-deficiencies like HIV.
  • Family history of Liver disease.

Common Symptoms

Some of the common symptoms of SBP include:[1]

  • Worsening of pre-existing ascites and progressive encephalopathy in a patient with cirrhotic ascites
  • Diffuse, continuous Abdominal pain is the hallmark of peritonitis, although some may be asymptomatic.

Less common symptoms of SBP

  • Low urine output
  • Thirst
  • Fatigue
  • Chills
  • Dizziness or weakness


References

  1. Such J, Runyon BA (1998). "Spontaneous bacterial peritonitis". Clin Infect Dis. 27 (4): 669–74, quiz 675-6. PMID 9798013.
  2. "Peritonitis - spontaneous: MedlinePlus Medical Encyclopedia".


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