Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0341503 (bacterial peritonitis)
 1,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bacterial peritonitis in patients with cirrhosis has a wide variety of clinical presentations. We report a group of 21 cirrhotic patients with secondary peritonitis from intra-abdominal sources. Seven had infected ascites. All of them had unrecognized secondary peritonitis which was diagnosed and treated as spontaneous (primary) bacterial peritonitis (SBP). Ascitic fluid analysis yielded a mean white blood cell count of 23,750 +/- 10,935/cu mm with 91.5% polymorphonuclear leukocytes, significantly higher than patients surveyed with SBP, 1,757 +/- 2,154/cu mm (P less than .001). Ascitic fluid protein levels were also higher than those typically seen in SBP: 4.4 +/- 1.5 gm/dl vs 0.8 +/- 0.4 gm/dl (P less than .001). The ascites: serum protein ratio was consistent with an exudate in those patients with secondary peritonitis (0.7 +/- 0.2) in contrast to typically infected transudate in patients with SBP (0.15 +/- 0.05) (P less than .001). Bacteriologic determination was similar: single organisms with Escherichia coli the most common. Often the clinical features and ascitic fluid analysis will not differentiate spontaneous from secondary peritonitis. It is, therefore, clinically prudent to consider secondary bacterial peritonitis in cirrhotic patients, especially with ascitic fluid WBC counts in excess of 5,000/cu mm and protein levels of greater than or equal to 2.5 gm/dl. Noninvasive diagnostic procedures should be included to search for sources of intra-abdominal infection.
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PMID:Secondary bacterial peritonitis in cirrhotic patients with ascites. 637 7

Four children aged 6-10 years (body weight 20-31 kg) and one adolescent patient (age 17 years, 32 kg) were treated by continuous ambulatory peritoneal dialysis (CAPD) over periods of 4-14 months totalling 39 months. Dialysis volumes of 1 liter for the pediatric patients and 1.5 liters for the adolescent patient were exchanged four times daily: glucose concentration was 15 milligrams during three cycles and 42.5 milligrams during one cycle. Bag exchanges and general care of the younger patients were primarily carried out by their mothers. Overall rehabilitation and patients' acceptance were good despite several complications, but full school attendance was only achieved in 2 children. Uremia and fluid balance were well controlled despite minimal dietary restrictions. Average serum urea was 20 mmol/l and creatinine 700 mumol/l. Glucose reabsorption from dialysate was 1-4 g/kg per day. Bacterial peritonitis occurred six times and responded well to appropriate treatment. Its incidence decreased from one episode every 4-5 months (before July 1980) to one every 8 months. Protein losses in the dialysate were 0.10-0.17 g/kg per day in 4 children; the serum protein was 57-69 milligrams. One child with sterile peritonitis lost 0.46 g protein per kg per day and became frankly hypoproteinemic (47 micrograms). Technical problems included cuff erosion (3 cases), and dislocation (1) or malposition (1) of the Tenckhoff catheter. Statural growth was unsatisfactory in 2 children treated for more than 9 months. CAPD was terminated by cadaveric renal transplantation in 3 patients, and by recovery of renal function in one. One patient is still on CAPD. CAPD offers a valuable alternative to hemodialysis in selected pediatric patients. However, the choice between the two methods should be left to specialized child centers. The long-term potential of CAPD still remains to be defined.
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PMID:[Continuous ambulatory peritoneal dialysis in children. 2 years' experience]. 705 Dec 75