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Do the clinical symptoms in cirrhotic patients with ascites indicate spontaneous bacterial peritonitis?

Hamed Aminiahidashti, Farzad Bozorgi, Hossein Montazer, Mohammad Hoseinnejad, Abolghasem Laali and Behnaz Raii

Spontaneous bacterial peritonitis (SBP) is the most common prevalent infection among patients with liver cirrhosis. Neglecting this infection in early time can be life threatening. The goal of this study was to determine physician clinical impression in confirming the diagnosis of Spontaneous bacterial peritonitis in patients for aspiration of abdominal fluid .In this study, 80 cirrhotic patients selected including: 32person with Spontaneous bacterial peritonitis and 48 patients without Spontaneous bacterial peritonitis who referred for aspiration of ascites fluid during February 2012 to January 2014. The sensitivity, specificity, positive and negative predictive values of clinical signs and symptoms (such as abdominal pain, fever, tachycardia, hypotension and encephalopathy) in diagnosis of Spontaneous bacterial peritonitis were evaluated through check list. Of 80 patients with cirrhosis, 32 had Spontaneous bacterial peritonitis but the rest 48 did not have (N=48). The highest sensitivity amounts were abdominal pain 93.75 %( 95%CI: 79.85-98.27) and the highest specificity amounts were for fever and tachycardia both 97.92 %( 95%CI: 89.1-99.63). Cirrhotic patients with ascites in the absence of abdominal pain do not have spontaneous bacterial peritonitis. In cirrhotic outpatient, abdominal paracentesis can be performed without sending samples for diagnostic testing to rule out spontaneous bacterial peritonitis.