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Indian Journal of Pathology: Research and Practice

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Spontaneous Bacterial Peritonitis: Diagnostic Importance of Ascitic Fluid Polymorphonuclear Cell Count, Biochemical and Microbiological Analysis

Sheetal Gautam Gole, Associate Professor, Department of Pathology, World College of Medical Science & Research & Hospital, Gurawar, Jhajjar, Haryana124103, India. , Mani Krishna* , Sheetal G. Gole** , Gautam N. Gole***

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Indian Journal of Pathology: Research and Practice 6(3(part-1)):p 640-645, Jul-Sep 2017. | DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.6317.23

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Abstract

Introduction: Ascites represents the pathological collection of fluid in the peritoneal cavity. Spontaneous bacterial peritonitis is the infection of the ascitic fluid. For its diagnosis, the number of polymorphonuclear cell count from the ascitic fluid obtained by diagnostic abdominal paracentesis should equal or exceed 250 cells/ cu.mm and from bacteriological cultures only one type of organism must be isolated. Biochemical analysis is also recommended. It is the most rapid and cost effective method for diagnosing cause of ascites. These patients must be treated with antibiotics aggressively as they have poor prognosis and high mortality if not treated early. Materials and Methods: Study was conducted at a tertiary care hospital, Haryana. All patients under went paracentesis within 24 hours of admission and were diagnosed before giving any antibiotics. Ascitic fluid was submitted in the Central Clinical Laboratory for total and differential leucocyte count, culture and biochemical investigations. Results: Present study included 38 patients of spontaneous bacterial peritonitis. Various clinical signs and symptoms were studied and followed by comparison statistics for all the variants. Statistical study was done to find the etiology for cirrhosis. Culture study revealed various organisms responsible for spontaneous bacterial peritonitis. Conclusion: Polymorphonuclear cell count in ascitic fluid without the need of positive culture is helpful in diagnosing spontaneous bacterial peritonitis. Mortality has decreased because of early diagnosis and effective treatment.

Keywords: Spontaneous Bacterial Peritonitis; Polymorphonuclear Cell Count; Serum/Ascites Albumin Gradient; Culture. 

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DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.6317.23

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