Spontaneous Bacterial Peritonitis (SBP)

Spontaneous Bacterial Peritonitis (SBP) is an infection of the fluid that accumulates in the abdomen, called ascitic fluid, which often occurs in people with severe liver disease. This condition affects the peritoneal cavity, the space within the abdomen that houses many organs. The infection happens without an obvious source like a ruptured organ, making it 'spontaneous.' It can cause symptoms such as abdominal pain, fever, and worsening of liver-related symptoms like confusion or swelling. The infection can be serious because it may lead to sepsis or kidney problems if not treated promptly. The main health impact is due to the infection spreading in the abdomen and the body's response to it, which can worsen liver function and overall health.

Spontaneous Bacterial Peritonitis (SBP) is defined as an infection of the ascitic fluid in the peritoneal cavity without an evident intra-abdominal surgically treatable source. It primarily occurs in patients with cirrhosis and ascites due to impaired immune defenses and bacterial translocation from the gut. The most common causative organisms are gram-negative enteric bacteria such as Escherichia coli and Klebsiella pneumoniae, but gram-positive cocci can also be involved. The condition is characterized by an elevated polymorphonuclear leukocyte (PMN) count in ascitic fluid, typically ≥250 cells/mm³, indicating inflammation. Clinically, SBP is significant because it can precipitate hepatic encephalopathy, renal failure, and systemic sepsis, contributing to high morbidity and mortality in cirrhotic patients. Early recognition and treatment are critical to improving outcomes.