Core EM - Emergency Medicine Podcast

Episode 131.0 – Spontaneous Bacterial Peritonitis (SBP)


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This week we explore the presentation, diagnosis and management of SBP.

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Tags: Gastroenterology, Infectious Diseases, SBP
Show Notes

Take Home Points

  • SBP is a difficult diagnosis to make because presentations are variable. Consider a diagnostic paracentesis in all patients presenting to the ED with ascites from cirrhosis
  • An ascites PMN count > 250 cells/mm3 is diagnostic of SBP but treatment should be considered in any patient with ascites and abdominal pain or fever
  • Treatment of SBP is with a 3rd generation cephalosporin with the addition of albumin infusion in any patient meeting AASLD criteria (Cr > 1.0 mg/dL, BUN > 30 mg/dL or Total bilirubin > 4 mg/dL)
  • Read More

    Oyama LC: Disorders of the liver and biliary tract, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2010, (Ch) 90: p 1186-1205.

    REBEL EM: Spontaneous Bacterial Peritonitis

    EMRAP: C3 Live Paracentesis Video

    LITFL: Spontaneous Bacterial Peritonitis

    SinaiEM: SBP Pearls

    REBEL EM: Should You Give Albumin in Spontaneous Bacterial Peritonitis (SBP)?

    Core EM: Episode 123.0 – Paracentesis Journal Update


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