Spontaneous bacterial peritonitis laboratory findings

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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]

Overview

Diagnosis necessitates paracentesis (needle drainage of the ascitic fluid) and laboratory confirmation of ascitic neutrophils > 250/mm³.

Laboratory Findings

Laboratory tests, most importantly ascitic fluid analysis is required for confirmation of diagnosis of spontaneous bacterial peritonitis.

• Complete blood count and differential count are tested to confirm infection.
• Serum electrolytes , creatinine to asses the renal function.
• Liver function tests are to performed for evaluation of cirrhosis.
• Blood cultures may be useful in sepsis
• Urine culture to rule out asymptomatic bacteruria

Ascitic Fluid Analysis

• Absoulte neutrophil count - a total count of >250 cells/mm³ along with positive cultures confirm the diagnosis of spontaneous bacterial peritonitis.
• Albumin concentration - it is important for the calculation of serum-ascites albumin gradient , this helps us in identifying the portal hypertension and prognosis.
• Protein concentration - low protein concentration is noticed in cases of spontaneous bacterial peritonitis which differentiates it from secondary bacterial peritonitis where it is normal.

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