Spontaneous bacterial peritonitis differential diagnosis

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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

SBP must be differentiated from other abdominal conditions presenting with fever and abdominal pain. It also has to be differentiated from secondary peritonitis, chemical peritonitis, peritoneal dialysis peritonitis, chronic tuberculous peritonitis.

Differentiating Spontaneous bacterial peritonitis from other Diseases

Spontaneous bacterial peritonitis presents with fever and abdominal pain. Diseases presenting with similar features include:

• Peritonitis: Presents with abdominal pain and guarding which is seldom seen in spontaneous bacterial peritonitis.
• Pyelonephritis : Pain in the costovertebral angle.
• Appendicitis: Presents with a typical history of radiation of pain from umbilicus to McBurney's point compared to diffuse pain in spontaneous bacterial peritonitis.
• PCT level was higher in advanced Liver cirrhosis patients with SBP than CNNA which indicated it may represent as a simple biomarker for differentiating SBP from CNNA. PCT may be a prognostic predictor to guide the empirical antimicrobial therapy in order to decrease the in-hospital mortality and the frequency of complications.

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