Take Home Points
- SBP is a difficult diagnosis to make because presentations are variable. Consider a diagnostic paracentesis in all patients presenting to the ED with ascites from cirrhosis
- An ascites PMN count > 250 cells/mm3 is diagnostic of SBP but treatment should be considered in any patient with ascites and abdominal pain or fever
- Treatment of SBP is with a 3rd generation cephalosporin with the addition of albumin infusion in any patient meeting AASLD criteria (Cr > 1.0 mg/dL, BUN > 30 mg/dL or Total bilirubin > 4 mg/dL)
Oyama LC: Disorders of the liver and biliary tract, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2010, (Ch) 90: p 1186-1205.
REBEL EM: Spontaneous Bacterial Peritonitis
EMRAP: C3 Live Paracentesis Video
LITFL: Spontaneous Bacterial Peritonitis
SinaiEM: SBP Pearls
REBEL EM: Should You Give Albumin in Spontaneous Bacterial Peritonitis (SBP)?
Core EM: Episode 123.0 – Paracentesis Journal Update