Secondary peritonitis differential diagnosis

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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

Differential Diagnosis

Differentiating secondary peritonitis from spontaneous bacterial peritonitis
Characteristic Spontaneous bacterial peritonitis Secondary peritonitis
Presentaion
  • Similar presentation but insidious onset unlike rapid onset in SBP
Microorganism
  • Monomicrobial involvement is common
  • No identifiable source of intra-abdominal infection
  • Polymicrobial involvement is common
  • Identifiable source of intra-abdominal infection, with or without perforation
Diagnostic Criteria

SBP is diagnosed in the presence of

  • Ascitic fluid PMN count of  ≥250/mm3
  • No evident intra-abdominal source of infection
  • Positive ascitic fluid bacterial culture
Diagnosed in the presence of
  • Positive ascitic fluid bacterial culture
  • Ascitic fluid PMN count of ≥250/mm3
  • Evidence of a source of infection (demonstrated at surgery or autopsy], either intra-abdominal or contiguous with the peritoneal cavity

References