What is a key diagnostic step in suspected spontaneous bacterial peritonitis?

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Multiple Choice

What is a key diagnostic step in suspected spontaneous bacterial peritonitis?

Diagnosing suspected spontaneous bacterial peritonitis hinges on analyzing the ascitic fluid obtained by paracentesis. The crucial finding is an ascitic fluid neutrophil count of 250 cells per cubic millimeter or higher, which confirms infection of the ascitic fluid. Culturing the fluid helps identify the causative organism and tailor therapy, but culture results can take time and may be negative in some cases, whereas the neutrophil threshold provides an immediate diagnostic criterion. Liver biopsy does not diagnose SBP, and renal function tests alone do not establish SBP. Ascitic fluid culture alone may miss cases without the neutrophil elevation, so combining paracentesis with both neutrophil count and culture is the best diagnostic step.

Diagnosing suspected spontaneous bacterial peritonitis hinges on analyzing the ascitic fluid obtained by paracentesis. The crucial finding is an ascitic fluid neutrophil count of 250 cells per cubic millimeter or higher, which confirms infection of the ascitic fluid. Culturing the fluid helps identify the causative organism and tailor therapy, but culture results can take time and may be negative in some cases, whereas the neutrophil threshold provides an immediate diagnostic criterion. Liver biopsy does not diagnose SBP, and renal function tests alone do not establish SBP. Ascitic fluid culture alone may miss cases without the neutrophil elevation, so combining paracentesis with both neutrophil count and culture is the best diagnostic step.

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