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

We present our experience with performing an exploratory laparotomy for peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Six of 134 patients undergoing CAPD during the study period underwent surgical intervention because of abdominal sepsis. Two patients had bacterial peritonitis without abscess formation or evidence of visceral perforation and they recovered readily and, in retrospect, may not have required an operation. Of the three patients with fungal abscesses, two died of subsequent bacterial sepsis, while one patient survived, albeit after drainage of a recurrent pelvic abscess. One patient died because of extensive intestinal gangrene that was misdiagnosed as CAPD-related peritonitis initially. Our experience with these cases suggests that fungal peritonitis is a life-threatening complication that may result in both formation of an abscess and death. Therefore, it warrants aggressive antifungal chemotherapy and surgical intervention should an abscess be discovered. In contrast, bacterial peritonitis should be treated with appropriate antibiotic regimens until adequate evidence indicating the presence of a surgical condition is obtained.
Arch Surg 1984 Dec
PMID:Ambulatory peritoneal dialysis. Exploratory laparotomy for peritonitis. 639 19

Transmission and scanning electron microscopy were used to examine mesothelial cells of the rat peritoneum in aseptic peritonitis caused by intraperitoneal starch injections and in bacterial peritonitis induced by injury to the large intestine. Active contraction of the mesotheliocytes was recorded in early stages of both the types of peritonitis. In aseptic peritonitis, that contraction was replaced by relaxation of the cells, whereas in bacterial peritonitis, by dystrophy and desquamation.
Biull Eksp Biol Med 1982 Dec
PMID:[Reaction of rat peritoneal mesothelial cells in aseptic and bacterial peritonitis]. 715 Jul 52

Lactate concentrations were measured in the ascitic fluid of patients using the Monotest Lactate Kit, an inexpensive, reliable bedside test that gives results within 15 min. The values were significantly higher in 24 patients with proven bacterial peritonitis, eight of them with spontaneous bacterial peritonitis, than in 53 patients with uninfected ascites of various other etiologies. In only two patients from the latter group, both with hepatic carcinoma and peritoneal metastases, were the values in the range found in bacterial peritonitis. Lactate determination was at least as sensitive as measurement of WBC levels for diagnosing peritonitis. Serial determinations in two patients with peritonitis showed declining values as the disease responded to treatment. The test has particular relevance for patients with spontaneous bacterial peritonitis, because this disease, which is potentially life-threatening although frequently asymptomatic, requires immediate treatment, yet currently depends on time-consuming culture procedures for diagnosis.
Dig Dis Sci 1981 Dec
PMID:Measurement of lactate in ascitic fluid: an aid in the diagnosis of peritonitis with particular relevance to spontaneous bacterial peritonitis of the cirrhotic. 730 56

From 1975 to 1977 we carried out postoperative, continuous peritoneal lavage of th abdomen in 41 patients with diffuse bacterial peritonitis. Although the peritonitis was arrested more frequently and earlier, comparison to 71 patients treated conventionally since 1970 showed an increase of wound complications and a prolongation of hospital stay from 25 to 44 days. The higher frequency of complications led to increased lethality from 42% to 54%. The harm by continuous peritoneal lavage out-weights the advantages, except for stercoraceous peritonitis.
Chirurg 1980 Dec
PMID:[Effectiveness of continuous drainage in diffuse bacterial peritonitis]. 747 53

We investigated 37 patients with ascites and liver cirrhosis in order to examine whether on the basis of correlation of cytokines and acute phase proteins of the ascitic fluid, prognosis of spontaneous bacterial peritonitis can be made. Significantly enhanced levels of interleukin-6, as well as acute phase reactants alpha-1-antitrypsin and C-reactive protein were found in the ascitic fluid of patients with spontaneous bacterial peritonitis. The levels of tumour necrosis factor alpha (TNF-alpha), neopterin, interleukin 2-receptor and granulocyte-macrophage colony stimulating factor were higher in patients with spontaneous bacterial peritonitis, but without statistical significance, whereas no differences were found between the interferon gamma, interleukin-2 and interleukin-1 levels. In addition, interleukin-6, TNF-alpha and neopterin levels were found to correlate significantly with the outcome of the disease. These findings show that acute phase reaction occurs in the ascitic compartment in correlation with the development of spontaneous bacterial peritonitis.
Eur J Clin Invest 1993 Dec
PMID:Spontaneous bacterial peritonitis is associated with high levels of interleukin-6 and its secondary mediators in ascitic fluid. 751 36

Sepsis due to Streptococcus pneumoniae has a high mortality. We report a retrospective review of 40 episodes of S pneumonia sepsis in adult patients during a two year period in a general hospital, that represented 11.3% of all sepsis observed in such hospital. Ninety two percent of infections were community acquired and in 95%, the portal of entry was the respiratory tract. Eighty five percent of patients had at least one risk factor such as alcohol abuse, unconsciousness or chronic pulmonary disease. Nine patients had suppurative complications (empyema in 4 cases, spontaneous bacterial peritonitis in 2, septic arthritis in 2 and meningitis in 1 case) and 12 (30%) died. The potential benefit of antipneumococcal vaccine as prevention should be considered in high risk subjects.
Rev Med Chil 1994 Dec
PMID:[Streptococcus pneumoniae septicemia. Analysis of 40 cases]. 765 13

Although spontaneous bacterial peritonitis is considered a precipitating factor of renal impairment in cirrhosis, no study specifically addressing this problem has been reported. This study was aimed at assessing the incidence, clinical course, predictive factors and prognosis of renal impairment in cirrhotic patients with peritonitis. Therefore, 252 consecutive episodes of spontaneous bacterial peritonitis in 197 patients were analyzed. Clinical and laboratory data obtained before and after diagnosis of peritonitis were considered as possible predictors of renal impairment and hospital mortality. Renal impairment occurred in 83 (33%) episodes, and in every instance it fulfilled the criteria of functional kidney failure. Renal impairment was progressive in 35 episodes, steady in 27 and transient in 21. Blood urea nitrogen and serum sodium concentration before peritonitis and band neutrophils count in blood at diagnosis were independent predictors for the development of renal impairment. Renal impairment was the strongest independent predictor of mortality during hospitalization. Other independent prognostic factors were blood urea nitrogen level before peritonitis, age, positive ascitic fluid culture and serum bilirubin level during infection. These results indicate that renal impairment is a frequent event in cirrhotic patients with spontaneous bacterial peritonitis that occurs mainly in patients with kidney failure before infection. Renal impairment is the most important predictor of hospital mortality in cirrhotic patients with spontaneous bacterial peritonitis.
Hepatology 1994 Dec
PMID:Renal impairment after spontaneous bacterial peritonitis in cirrhosis: incidence, clinical course, predictive factors and prognosis. 798 50

Selective intestinal decontamination (SID) for 7 days with norfloxacin (NF) was performed in 15 patients with schistosomal hepatic fibrosis (SHF) and low-protein ascites. Changes in ascitic fluid (AF) opsonic activity and complement3 (C3), complement4 (C4), total protein (TP) and albumin concentrations after NF therapy were compared with those of a control group composed of 15 untreated patients with similar characteristics. After oral NF administration, the mean % changes of AF opsonic activity & AF C3 & TP concentrations showed significant increases and were significantly higher than those in the control group. There were direct correlations between mean % changes in AF opsonic activity and C3 concentrations (r = 0.62). AF opsonic activity and TP concentrations (r = 0.54) and AF C3 and TP concentrations (r = 0.57) in the NF group. On the other hand, the AF C4 and albumin concentrations were not significantly changed in any group at the end of the study. Based on the results of the present study, it can be concluded that short-term NF therapy in patients with SHF and low-protein ascites increased AF opsonic activity and AF C3 and TP concentrations and hence, AF bactericidal activity. Study of larger numbers of patients for longer periods will determine if these beneficial effects on NF translate into a decreased incidence of spontaneous bacterial peritonitis in patients with chronic liver disease and high-risk of infection.
J Egypt Soc Parasitol 1993 Dec
PMID:Selective intestinal decontamination in patients with schistosomal hepatic fibrosis and low-protein ascites. 830 39

Listeria monocytogenes is a gram-positive coccobacillus that produces infections in both the normal and the compromised host. Symptomatic bacteremia and pulmonary infection or meningitis are the most common clinical presentations in adults. According to a current review of the literature, Listeria is a rare bacteria that may produce spontaneous bacterial peritonitis (23 cases reported). Listeria peritonitis occurs in more than two-thirds of the cases in patients with chronic liver disease, but may also occur in patients with malignancy or undergoing peritoneal dialysis. We describe two cases of SBP in cirrhotic patients, one with alcoholic cirrhosis and other due to HCV infection. One patient also presented with acute meningitis. Peritonitis due to Listeria was clinically and analytically similar to any SBP. Third-generation cephalosporins commonly used in the therapy of SBP, are ineffective in this infection. Ampicillin is the drug of choice, although it should be used in combination therapy usually with an aminoglycoside. The mortality from Listeria peritonitis is similar to that of other SBP (17%).
Rev Esp Enferm Dig 1995 Dec
PMID:[Spontaneous bacterial peritonitis caused by Listeria monocytogenes]. 856 97

Male Wistar rats injected intraperitoneally (i.p.) with 10(9) U Escherichia coli ATCC 25922 developed acute bacterial peritonitis. Hemodynamic studies, with microspheres labeled with 103Ru 57Co, and 113Sn, were performed before, 30 min after bacterial injection, and 30 min after administration of either the platelet-activating factor (PAF) antagonist BN-52021 (5 mg/kg body weight) or isotonic saline. A blood sample of 0.3 ml was obtained for bacterial culture and endotoxemia measurements. Plasma PAF levels were measured in a different group of 10 control rats and 20 animals with experimental peritonitis. One group of rats injected with E. coli (n = 13) displayed hyperdynamic circulation, with an increase in cardiac output (CO) from 15.1 +/- 1.2 to 19.4 +/- 1.1 ml/min/100 g body weight and a decrease in total peripheral resistance (TPR) from 19.5 +/- 2.4 to 14.9 +/- 1.1 dynes.s.cm-5 10(-4). Furthermore, these rats showed high endotoxin blood concentrations and low hemoculture levels. The remaining 7 peritonitic rats showed a significant decrease in CO from 16.3 +/- 1.6 to 12.7 +/- 1.2 ml/min/100 g body weight and an increase in TPR from 17.3 +/- 1.8 to 22.6 +/- 2.8 dynes.s.cm-5 10(-4). In addition, these rats showed low endotoxin blood concentrations and high hemoculture levels. Endotoxin blood concentrations were positively correlated with the change in CO (r = 0.87, p < 0.05), and cell hemocultures were positively correlated with CO (r = 0.89, p < 0.05). Rats with high endotoxin blood levels showed higher PAF plasma levels than control rats or peritonitic rats with low endotoxin blood levels. When peritonitic rats were injected with the specific PAF-receptor blocker BN-52021 (5 mg/kg body weight) as a bolus, CO and TPR returned to baseline values in both groups of animals. These data suggest that the hemodynamic changes induced by bacterial peritonitis depend on endotoxemia and bacteremia in opposite ways. In addition, PAF appears to be involved in both the hyperdynamic and hypodynamic hemodynamic changes shown by peritonitic rats.
J Cardiovasc Pharmacol 1995 Dec
PMID:Factors associated with hyperdynamic or hypodynamic circulation and role of platelet-activating factor in hemodynamic alterations in bacterial peritonitis in conscious rats. 860 31


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