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Query: UMLS:C0341503 (
bacterial peritonitis
)
1,303
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Ascites is a late and uncommon symptom of Chronic Granulomatous Disease (CGD) of childhood following liver damage with
portal hypertension
due to hepatic granulomatosis. The Authors describe two patients with CGD, in whom ascites was the main symptom in the first case and the initial symptom in the second case. Ascites in these cases was not due to liver fibrosis but it was a consequence of primary
bacterial peritonitis
.
...
PMID:[Ascites as an unusual manifestation of chronic granulomatous disease in childhood]. 152 2
Rational treatment of portal hypertensive complications requires a knowledge of the cause of
portal hypertension
and an assessment of the severity of liver disease. In the United States, chronic liver disease, usually due to alcohol, is the most common underlying cause. The history, physical examination, and laboratory analysis are usually sufficient to confirm the presence of underlying liver disease. If there is any question as to the etiology of
portal hypertension
, however, a more complete evaluation is required, whether the presenting complication is ascites, variceal bleeding, or hypersplenism. Usually, such an evaluation will require a liver biopsy, portal pressure measurement, and angiography. Occasionally, a noninvasive evaluation will be sufficient, but the value of these noninvasive parameters is still under investigation. Surgical mortality generally depends on the severity of the liver disease. Therefore, surgical intervention must be carefully considered in comparison to other therapeutic modalities depending on the patient's hepatic functional reserve. Secondary
bacterial peritonitis
due to perforation requires surgery regardless of the severity of the underlying liver disease.
...
PMID:Diagnosis and hemodynamic assessment of portal hypertension. 218 5
To assess the risk of development of spontaneous
bacterial peritonitis
in relation to ascitic fluid opsonic activity, routine admission abdominal paracentesis was performed on 119 patients during 141 hospitalizations. Paracentesis was repeated if evidence of peritonitis developed during the hospitalization. The ascitic fluid opsonic activity (0.2 +/- 0.5 log kill) of 24 spontaneously infected specimens was significantly (p less than 0.001) lower than that of the group with sterile
portal hypertension
-related ascites (0.8 +/- 1.1 log kill), and significantly lower than the group with ascites of miscellaneous type (2.4 +/- 1.0 log kill, p less than 0.001). The C3 and C4 concentrations of the spontaneous peritonitis specimens were also significantly lower than in the specimens from the other groups. Of the 55 patients whose initial sterile ascitic fluid opsonic activity was less than 0.2 log kill, 8 (14.5%) developed spontaneous
bacterial peritonitis
during the hospitalization; whereas none of the 70 patients with sterile ascitic fluid opsonic activity greater than or equal to 0.2 log kill developed spontaneous peritonitis. This difference in the risk of development of peritonitis was significant (p less than 0.01). Patients with deficient ascitic fluid opsonic activity are predisposed to spontaneous
bacterial peritonitis
.
...
PMID:Patients with deficient ascitic fluid opsonic activity are predisposed to spontaneous bacterial peritonitis. 337 81
To assess the risk of development of spontaneous
bacterial peritonitis
in relation to the ascitic fluid total protein concentration, routine admission abdominal paracentesis was performed on a group of 107 patients during 125 hospitalizations. The paracentesis was repeated if evidence of peritonitis developed during hospitalization. Twenty-one episodes of spontaneous peritonitis (or its culture-negative variant) were documented in 17 patients. The ascitic fluid protein concentration in the spontaneous peritonitis group (0.72 +/- 0.53 g/dl) was significantly lower (p less than 0.001) than that in the group of patients with sterile
portal hypertension
-related ascites (1.36 +/- 0.89 g/dl) and was significantly lower than that of patients with ascites due to miscellaneous causes. Of the patients whose initial sterile ascitic fluid protein concentration was less than or equal to 1.0 g/dl, 7 of 47 (15%) developed spontaneous peritonitis during their hospitalization; whereas only 1 of 65 (1.5%) patients who had an initial sterile ascitic fluid protein concentration greater than 1.0 g/dl developed spontaneous peritonitis. This difference in risk of development of peritonitis in relation to initial ascitic fluid protein concentration was also significant (p less than 0.01). Low-protein-concentration ascitic fluid predisposes to spontaneous
bacterial peritonitis
.
...
PMID:Low-protein-concentration ascitic fluid is predisposed to spontaneous bacterial peritonitis. 377 Mar 58
The mortality rate in spontaneous
bacterial peritonitis
is reportedly high. Patients rarely survive the initial infection. Most patients die either because of infection or end-stage liver disease. A patient with alcoholic cirrhosis and
portal hypertension
with five distinct episodes of spontaneous
bacterial peritonitis
over a 2 1/2-year period is described.
...
PMID:Chronic recurrent spontaneous bacterial peritonitis. 663 66
Spontaneous bacterial peritonitis in liver cirrhosis is due to the passage of intestinal bacteria into intestinal lymph vessels, systemic circulation and ascitic fluid. It may occur in patients with severe
portal hypertension
and hepatic failure, impaired reticuloendothelial phagocytic activity and low ascitic fluid opsonic activity. Spontaneous bacterial peritonitis is a monomicrobial infection usually caused by gram-negative bacteria. The treatment of choice of spontaneous
bacterial peritonitis
is cefotaxime. Several subgroups of cirrhotic patients have been shown to be predisposed to develop spontaneous
bacterial peritonitis
, including cases with gastrointestinal hemorrhage, patients with high serum bilirubin and low ascitic fluid protein concentration (< 1 g/dl), and patients who had recovered from an episode of spontaneous
bacterial peritonitis
. Since spontaneous
bacterial peritonitis
is associated with a relatively high in-hospital mortality rate (20-40%), prophylactic measures to prevent this infection are required. Short-term and long-term selective intestinal decontamination with oral norfloxacin has proved highly effective in preventing bacterial infection and spontaneous
bacterial peritonitis
in bleeding cirrhotic patients as well as recurrence of spontaneous
bacterial peritonitis
.
...
PMID:Spontaneous bacterial peritonitis in liver cirrhosis: treatment and prophylaxis. 784 26
The prevalence of hepatitis C virus (HCV) infection in patients with chronic liver disease (CLD) in Israel has not yet been reported. A retrospective analysis was performed on the first 92 consecutive patients referred to our Liver Unit with serologically confirmed antibodies to hepatitis C virus (anti-HCV) who had evidence for chronic hepatitis, cirrhosis, and hepatocellular carcinoma. We compared 31 patients who were anti-HCV positive with 61 patients who had evidence for both previous or present infection with hepatitis B virus (HBV) as well as HCV. Dual infection was significantly more prevalent in Jewish patients of non-Ashkenazi origin, who were also characterized by higher rates of
portal hypertension
manifested by ascites, bleeding esophageal varices as well as hepatic encephalopathy and spontaneous
bacterial peritonitis
. We conclude that dual infection of HBV and HCV was found in 66% of patients with anti-HCV positive liver disease in Jerusalem, and that these patients develop more serious complications than CLD patients with anti-HCV alone.
...
PMID:Chronic hepatitis C virus infection with exposure to hepatitis B virus. 817 25
Bacterial peritonitis
presents with classic symptoms of fever and abdominal pain. Some patients, however, are completely asymptomatic. Death in the short term is considerable, especially in patients with alcoholic cirrhosis. Cystic fibrosis patients occasionally develop biliary cirrhosis and may have secondary hypersplenism, varices, and ascites. These patients should be at risk for spontaneous
bacterial peritonitis
. Spontaneous bacterial peritonitis is described in two patients with longstanding hepatic cirrhosis secondary to cystic fibrosis. Both had required splenectomy for complications of
portal hypertension
. This is a previously unreported, but potentially fatal, complication of cystic fibrosis liver disease. Early diagnostic paracentesis is essential so that appropriate acute management, including antimicrobial treatment can be started. In the long term, these patients deserve immediate paracentesis for any evidence of recurrence. Whether the patient is treated with chronic (continuous) antimicrobial prophylaxis or only receives antimicrobial treatment during periods when bacteraemia is possible (for example, dental work, bronchoscopy), it would seem reasonable in patients with cystic fibrosis to use a wide spectrum antimicrobial agent with activity against Pseudomonas aeruginosa, other common Gram negative organisms, and Staphylococcus aureus.
...
PMID:Spontaneous bacterial peritonitis in cystic fibrosis. 820 May 73
Ascites is a manifestation of cirrhosis-induced
portal hypertension
. Pathogenesis is the result of a complex interaction of mechanical, humoral and neural events. Impaired excretion of sodium by the kidney is a hallmark of ascites, which is addressed by many of the available treatment options. Ascites contributes significantly to the morbidity and mortality rates of cirrhosis by increasing the likelihood of such fatal complications as variceal bleeding, hepatorenal syndrome and spontaneous
bacterial peritonitis
. Most ascitic patients respond to conservative or medical treatment. Five to 10 percent of the patients are refractory and may be candidates for surgical treatment. Peritoneovenous shunting is effective, and while safety is improved by following certain guidelines, its impact on survival is not clear. Portacaval shunting is also safe and effective. The use is accompanied by a prohibitively high morbidity rate because of encephalopathy, which limits its application despite what seems to be a significant impact on survival.
...
PMID:Pathophysiologic factors and management of ascites. 842 10
A case of spontaneous
bacterial peritonitis
(SBP) developed in an old man whose ascitic fluid was related neither to
portal hypertension
nor nephrotic syndrome, but with severe hypoalbuminemia emerged after a massive bleeding from a gastric ulcer in a malnutrition state. Ascitic fluid, increasing day by day, yielded Enterobacter cloacae and Bacteroides fragilis. Though autopsy was not carried out because of refusal of his family, neither liver necropsy, nor abdominal CT scan nor repeated abdominal ultrasonography showed findings suggesting existence of liver cirrhosis. In the presence of his ascites, the extent of a chemiluminescence (CL) response of polymorphonuclear cells from volunteers was significantly lower than that of his serum. This report shows that SBP can develop in a patient with ascites unrelated to
portal hypertension
when ascitic fluid induces little CL response.
...
PMID:[A case of spontaneous bacterial peritonitis with ascites caused by hypoproteinemia after a massive bleeding from a gastric ulcer]. 845 Feb 77
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