Case challenge · Gastroenterology / Hepatology / Emergency · teaching

Spontaneous Bacterial Peritonitis (SBP) — Pathway · case challenge

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Case #1Gastroenterology / Hepatology / Emergency

📋 Case data

Ascitic PMN countPMN <250

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Step 1 / 1 · Ascitic PMN count

In a cirrhotic with ascites, the ascitic neutrophil (PMN) count on diagnostic paracentesis?

💡 Cirrhotic ascites with suspected infection (fever, abdominal pain, worsening encephalopathy, deteriorating renal function; may be asymptomatic) → diagnostic paracentesis. Ascitic PMN ≥250/mm3 (0.25×10^9/L) = SBP. Culture-negative neutrocytic ascites (PMN ≥250, culture negative) is treated as SBP. Inoculate ascites into blood-culture bottles at the bedside. SAAG ≥1.1 indicates a portal-hypertension background.

For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.