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Template:Diagnosis of SBP
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Diagnosis of SBP via Ascitic Fluid Analysis
Standard Evaluation
- Paracentesis results supporting a diagnosis of SBP:
- Absolute neutrophil count (PMNs) ≥250
- Bacteria on gram stain (single type)
- SAAG > 1.1
- Diagnostic of portal hypertension with 97% accuracy[1]
- SBP rarely develops in patients without portal hypertension
- Protein < 1, Glucose > 50 (otherwise concern for secondary bacterial peritonitis)
For bloody tap, subtract 1 WBC for every 250 RBC[2]
If on Peritoneal Dialysis (CAPD)
SBP if:
- >100 total WBCs OR >50% neutrophils
If on Nightly APD
SBP if:
- >50% neutrophils
- Amylase (>100 suggestive of intra-abdominal process)
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