Spontaneous bacterial peritonitis history and symptoms

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

Overview

The main manifestations of SBP are acute abdominal pain, tenderness, fever. Symptoms may be masked in the elderly and ~30% may be asymptomatic. Patients may also complain of worsening ascites. hepatic encephalopathy may be the only manifestation of SBP, especially in people with cirrhosis and ascites. The clinical presentation of SBP is highly variable as it may manifest as a relatively insidious colonization without signs and symptoms or it can rapidly develop as a septic syndrome.[1]


History

A directed history should be obtained to ascertain the precipitant of this condition, 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:[2][3]

  • Worsening of pre-existing ascites and progressive encephalopathy in a patient with cirrhotic ascites
  • Diffuse, continuous abdominal pain may be present and few patients may be asymptomatic.

Less common symptoms of SBP

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


References

  1. Hoefs, John C.; Ruyon, B.A. (1985). "Spontaneous bacterial peritonis". Disease-a-Month. 31 (9): 1–48. doi:10.1016/0011-5029(85)90002-1. ISSN 0011-5029.
  2. Such J, Runyon BA (1998). "Spontaneous bacterial peritonitis". Clin Infect Dis. 27 (4): 669–74, quiz 675-6. PMID 9798013.
  3. Chinnock B, Hendey GW, Minnigan H, Butler J, Afarian H (2013). "Clinical impression and ascites appearance do not rule out bacterial peritonitis". J Emerg Med. 44 (5): 903–9. doi:10.1016/j.jemermed.2012.07.086. PMID 23473819.
  4. "Peritonitis - spontaneous: MedlinePlus Medical Encyclopedia".


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