CLINICAL AND LABORATORIAL FINDINGS OF SPONTANEOUS BACTERIAL PERITONITIS IN PATIENTS OF UNIVERSIDADE BRAZ CUBAS- SCHOOL HOSPITAL, MOGI DAS CRUZES, BRAZIL

Introduction: spontaneous bacterial peritonitis (SBP) is a severe complication in patients with liver cirrhosis and ascitis, with mortality rate around 20-37%. Objectives: to review the literature and establish the clinical manifestation and laboratorial characteristics of the patients diagnosed as SBP. Patients and methods: a retrospective study of 19 medical documents in period from January, 2005 to July, 2007 was performed in Universidade Braz Cubas- School Hospital Results: the mean age of the patients was 75, predominantly men. The average hospitalize period was 9 days. The most common symptoms were: abdominal pain, ascitis and jaundice. The most common cause of chronic hepatophaty was viral Hepatitis C, present in 33% of cases. The majority of SBP was communal with leucometry over 250 polymorphonuclear leukocyte/ mm³ in 78% of cases, only one presenting positive culture of the ascitic fluid, isolating Staphylococcus aureus, whereas 50% of the hemocultures were positive, with Escherichia coli isolated. Only one case presented bacterioscopic exam positive, with Gram positive coccus. The laboratory blood exams present the following average results: leukocyte count 9216,67/mm³ with 75,33% neutrophil, prothrombin time was 54,3%, creatinine 1,58mg/dl and albumin 2,44g/dl. The treatment used was third and fourth generation cephalosporins per 10 days. The outcome of the patients was: upturn and released from hospital in 17 cases, 1 death and 1 case hospital transference. Conclusions: findings correspond to the literature, less the fact of the ascitic fluid collection were done by routine method. Nowadays, the best method used to collect ascitic fluid is direct inoculation of ascites into hemoculture bottle method with a higher positivity of 49,8%. Therefore, the knowledge about SBP is essential, as diagnosed methods and clinical manifestations looking for early treatment to reduce the mortality.

Jansen PLM. Spontaneous bacterial peritonitis: detection, treatment and prophylaxis in patients with liver cirrhosis. Neth J Med. 1997;51:123-8
Filik L, Unal S. Clinical and laboratory features of spontaneous bacterial peritonitis. East Afr Med J. 2004;81(9):474-9
Santos MSC, Martins HS. Emergências relacionadas à cirrose. In: Martins HS, Scalabrini Neto A, Velasco IT. Emergências Clínicas Baseada em Evidências. São Paulo: Atheneu; 2005.p.393-409