COMMENTARY

Spontaneous bacterial peritonitis

Early events in spontaneous bacterial peritonitis

B A Runyon

Correspondence to:
Correspondence to:
Professor B A Runyon
Chief, Liver Service, Loma Linda University Medical Center, 11234 Anderson Street, Room 1556, Loma Linda, California, 92354, USA; Brunyon@ahs.llumc.edu

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Insight into the very early events in the pathogenesis of spontaneous bacterial peritonitis

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Keywords: ascites; bacterial peritonitis; bacterial translocation; cirrhosis; cytokines

The first 150 words of the full text of this article appear below.

The database regarding spontaneous bacterial peritonitis (SBP) has increased dramatically in the past 33 years since this phrase was first coined by Harold Conn.¹ In the remote past this easily treatable cause of deterioration of patients with advanced cirrhosis was underdiagnosed and undertreated. This undoubtedly led to many unnecessary deaths, which were probably viewed as mysterious at the time.

Now we know that SBP is quite common, with a prevalence of >20% on admission to the hospital, prior to the era of prevention.² We know who is at high risk—patients with cirrhosis and (a) prior SBP, (b) low protein ascites, or (c) gastrointestinal bleeding.³ We also know how to diagnose, treat, and even prevent this potentially fatal infection.^3,4

Even the "spontaneous" nature of this infection has been largely resolved in recent years. We now know that the gut is the source of most of the bacteria that . . . [Full text of this article]

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This article has been cited by other articles:

• Koulaouzidis, A, Bhat, S, Karagiannidis, A, Tan, W C, Linaker, B D (2007). Spontaneous bacterial peritonitis. Postgrad. Med. J. 83: 379-383 [Abstract] [Full Text]