Postępy w diagnostyce i terapii samoistnego zapalenia otrzewnej u pacjentów z marskością wątroby.

Spontaneous bacterial peritonitis (SBP) is a common infection in patients with liver cirrhosis and ascites, which significantly worsens the prognosis as to the incidence and survival in this group of patients. Usually develops as a result of bacterial translocation of intestinal flora and its products. SBP symptoms are often non specific enough, and depend on the intensity of symptoms usually associated with progression of liver disease occurring earlier (abdominal enlargement, failure of diuretic therapy, the severity of encephalopathy). Diagnosis of ascites infection in the SBP is mainly based on the result of microbiological and morphological assessment of ascetic fluid obtained from the diagnostic paracentesis. Empirical antibiotic therapy should be implemented immediately after the diagnosis of SBP and cover the most common pathogens - as has been shown for nearly 80% of the SBP is responsible Gram-negative bacterial flora in 20% of cases of Gram-positive cocci. In addition, demonstrated the need to consider antibiotic prophylaxis in certain patient groups. These include: patients who have bleeding from the gastrointestinal tract, with a low content of protein in the ascites fluid without prior history of SBP (primary prevention), a history of SBP (secondary prevention) and with refractory ascites. Although the observed occurrence of SBP is an important signal of the need for implementation of procedures eligible for liver transplantation. [ABSTRACT FROM AUTHOR]