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Query: UMLS:C0341503 (bacterial peritonitis)
 1,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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.
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PMID:[A case of spontaneous bacterial peritonitis with ascites caused by hypoproteinemia after a massive bleeding from a gastric ulcer]. 845 Feb 77

A common characteristic of the patients with alcoholic liver cirrhosis is malnutrition, which in turn favors a large number of complications. The development of spontaneous bacterial peritonitis is partly related to the low concentrations of total proteins an C3 in the ascitic liquid. The objective of the present study has been to analyze the influence of the nutritional state on the characteristics of the ascitic liquid, before and after three weeks of an enteral nutritional support supplement, in a group of patients with alcoholic liver cirrhosis. On the whole, 38 patients were studied, who received a standard diet of 45 grams of protein and 2308 calories per day, additionally giving 27 of them an enteral diet of 1680 calories, composed of 294 grams of carbohydrates, 36.9 grams of fat, and 43.5 grams of protein in the form of branched chain amino acids. The group of patients supplemented in their diet presented a positive nitrogen balance which was significantly superior to the unsupplemented (p < 0.001). The nutritional state showed a significant improvement after three weeks with an additional enteral diet (p < 0.025). This improvement was translated into an also significant increase in the concentrations of total proteins and C3 of the ascitic liquid in the same group of patients (p < 0.001 for both parameters). These data appear to show that the nutritional support in patients with alcoholic cirrhosis may be a good strategy in the fight against some complications.
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PMID:[Influence of the nutritional status on the characteristics of the ascitic fluid in alcoholic hepatic cirrhosis]. 896 3

Bacterial translocation (BT) has been involved in the pathogenesis of spontaneous bacterial peritonitis (SBP) in experimental cirrhosis. Because malnutrition is a common feature in cirrhosis, the aim of this study was to evaluate the effect of nutrition on BT and SBP. We induced cirrhosis in 44 Sprague-Dawley rats by administration of oral CCl4, and, afterward, 26 animals were maintained with dietary restriction. Cultures of mesenteric lymph nodes (MLN), peripheral and portal blood, liver, and spleen were performed. SBP occurred in 48% of the rats with ascites, this being more frequent in the malnourished animals (80%) than in control rats (29%). BT appeared in all the rats with SBP (100%) but only in 57% without it. In the malnourished animals, the BT rate was 95%, while it was 30% in the control group. These results suggest that malnutrition increases the BT rate and the risk of developing SBP in experimental cirrhosis, and that BT is frequent in cirrhosis and may play a role in the development of SBP.
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PMID:Influence of malnutrition on the prevalence of bacterial translocation and spontaneous bacterial peritonitis in experimental cirrhosis in rats. 918 48

Maternal factors that might impair the integrity of the late gestation placental barrier to enteroviruses were evaluated. Mice were inoculated with Theiler's murine encephalomyelitis virus (TMEV) on day 10-13 of gestation and sacrificed on day 16-18. Placentas and fetuses from dams with advanced age, forced daily swimming, short-term clamping of uteroplacental blood vessels, restricted dietary intake, or bacterial peritonitis were compared with tissues from TMEV-infected control mice. Increased maternal age, exercise, and malnutrition were associated with reduced fetal weight, and disturbed uteroplacental blood flow and severe malnutrition were associated with abnormal placental and fetal morphology. TMEV infection was observed sporadically by culture or in situ hybridization (or both) in fetuses from dams with interrupted uteroplacental blood flow, bacterial peritonitis, and older age but not in fetuses from control infected mice. This suggests that maternal factors, such as compromised uteroplacental blood flow, concomitant infection, and advanced age, may increase the risk of transplacental fetal infection.
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PMID:Maternal factors affecting the integrity of the late gestation placental barrier to murine enterovirus infection. 920 48

Intestinal bacterial overgrowth (IBD) is very frequent in patients with chronic hepatopathies. Causes of IBO, although not entirely known, principally are: the hepatopathy, the alcoholism and the alterations produced by these two factors, such as achylia (and above all hypochlorhydria), decrease in the secretion of IgA, and malnutrition. On the other hand, the IBO increases the severity of the hepatopathy and frequently produces a bacterial peritonitis. All these data suggest that the IBO play an important role increasing the hepatopathy severity and consequently is a factor to bear in mind.
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PMID:[Intestinal bacteria overgrowth in chronic hepatopathies]. 1042 Sep 29

Tertiary or recurrent peritonitis can occur after any operation for secondary bacterial peritonitis. The major risk factors for the development of tertiary peritonitis include malnutrition, a high Acute Physiology and Chronic Health Evaluation II score, the presence of organisms resistant to antimicrobial therapy, and organ system failure. Most patients with tertiary peritonitis will have fever and leukocytosis, even though other signs of infection may be absent. The management of tertiary peritonitis should include the provision of appropriate physiologic support, the administration of antimicrobial therapy, and operation or intervention to control the source of contamination and to decrease the bacterial load. Antibiotic-resistant organisms and bacteremia are present more commonly and mortality is greater in patients with tertiary peritonitis. Early recognition and effective intervention are critical to achieving a successful outcome.
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PMID:Evaluation and management of tertiary peritonitis. 1069 46

Gastrointestinal dysfunction in patients with cirrhosis may contribute to complications such as malnutrition and spontaneous bacterial peritonitis. To determine whether cirrhotic patients with ascites have altered intestinal function, we compared intestinal permeability and absorption in patients with liver disease and normal subjects. Intestinal permeability and absorption were investigated in 66 cirrhotic patients (48 with ascites, 18 without ascites) and 74 healthy control subjects. Timed recovery of 3-O-methyl-D-glucose, D-xylose, L-rhamnose, and lactulose in urine following oral administration was measured in order to assess active and passive carrier-mediated, and nonmediated, absorptive capacity, as well as intestinal large-pore/small-pore (lactulose/rhamnose) permeability. Test sugars were measured by quantitative thin-layer chromatography and results are expressed as a percentage of test dose recovered in a 5-h urine collection. Sugar excretion ratios relating to small intestinal permeability (lactulose/rhamnose) and absorption (rhamnose/3-O-methyl-D-glucose) were calculated to avoid the effects of nonmucosal factors such as renal clearance, portal hypertension, and ascites on the recovery of sugar probes in urine. Compared with normal subjects, the mean lactulose/rhamnose permeability ratio in cirrhotic patients with ascites was significantly higher (0.058 vs. 0.037, P < 0.001) but not in cirrhotic patients without ascites (0.041 vs. 0.037). Cirrhotic patients with ascites had significantly lower mean recoveries of 3-O-methyl-D-glucose (23.0 vs. 49.1%; P < 0.001), D-xylose (18.8 vs. 34.5%; P < 0.001), L-rhamnose (4.0 vs. 9.1%; P < 0.001), and lactulose (0.202 vs. 0.337%; P < 0.001) than normal subjects. However, the mean rhamnose/3-O-methyl-D-glucose ratio was the same in cirrhotic patients with ascites as normal subjects (0.189 vs. 0.189), indicating that the reduction in probe recovery was due to nonmucosal factors. Compared with normal subjects, cirrhotic patients with ascites have abnormal intestinal permeability, measured by urinary lactulose/rhamnose excretion, and normal small intestinal absorption, assessed by the urinary rhamnose/3-O-methyl-D-glucose ratio. Low urine recovery of sugar probes found in cirrhotic patients appears to be the result of nonintestinal factors affecting clearance rather than reduced intestinal absorption.
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PMID:Assessment of intestinal permeability and absorption in cirrhotic patients with ascites using combined sugar probes. 1518 67

Chronic liver disease results in more than 1 million physician visits and more than 300,000 hospitalizations per year in the United States. More than 27,000 patients annually progress to end-stage liver disease (ESLD), liver failure, or death. Patients with ESLD experience such complications as encephalopathy, malnutrition, muscle wasting, ascites, esophagogastric variceal hemorrhage, spontaneous bacterial peritonitis, fatigue, and depression. Despite significant improvements in palliation, patients' quality of life diminishes and their disease will often inexorably progress. Liver transplantation, a valid treatment option, increases life and reduces many symptoms. With the current shortage of organs, up to 10% to 15% of these patients die without receiving an organ. Many patients also are not candidates for transplantation due to comorbid illness. In addition, some patients receive a transplant but succumb to complications of the transplant itself. Such patients and families face the conundrum of a potentially treatable yet often fatal illness. Through the case of a 55-year-old woman with a life-long history of hepatitis B virus infection who is awaiting transplant, we discuss the transplant eligibility process and the struggle with maintaining hope for a cure in the face a life-threatening illness. In all of these circumstances, the health care team must combine elements of palliative care with life-sustaining therapy to maximize the patient's quality and quantity of life.
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PMID:Integrating palliative care for liver transplant candidates: "too well for transplant, too sick for life". 1677 29

Spontaneous bacterial peritonitis is a serious and frequent complication in childhood nephrotic syndrome. However, this type of complication is very rare in adult nephrotic patients. In the review realized only 15 cases are published with this complication, and none of them after the year 2000. Later we expose the case of a male of 25 years old, proceeding of senegal, with spontaneous bacterial peritonitis, acute renal failure and coagulopatia for malnutrition as form of presentation of a nephrotic syndrome flowery. Besides across the contributed case different aspects of the epidemiology and of the managing of these patients are discussed as well as the last publications on the options of treatment of the glomerulopatia responsible of the clinical symptoms.
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PMID:[Spontaneous bacterial peritonitis as form of presentation of idiophatic nephrotic syndrome in a black adult]. 1819 54

Sclerosing peritonitis describes the development of a peel or rind of fibrosis that spreads over the peritoneal surface and can lead to recalcitrant ascites, bowel obstruction, and sepsis. It is well described as a complication of peritoneal dialysis, especially with episodes of bacterial peritonitis. It is also a complication of end-stage liver disease with ascites and liver transplantation. This article describes 3 cases of sclerosing peritonitis present at the time of liver transplantation or soon after. All 3 patients had massive refractory ascites with episodes of spontaneous bacterial peritonitis prior to transplantation. Two patients had evidence of a fibrous peel at the time of transplantation. Postoperatively, all 3 patients continued to have refractory ascites and episodes of peritonitis, along with partial small bowel obstructions, abdominal pain, and malnutrition. Two patients also had constriction of the graft, including biliary obstruction and inferior vena cava and outflow obstruction, which has not been previously described. All 3 patients eventually died from complications related to the sclerosing peritonitis.
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PMID:Sclerosing peritonitis and mortality after liver transplantation. 1932 14


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