Spontaneous Bacterial Peritonitis: A Prospective Investigation in Predominantly Nonalcoholic Cirrhotic Patients

Two hundred and twenty-four consecutive inpatients with cirrhosis, mostly of nonalcoholic etiology, and ascites were prospectively investigated on admission for spontaneous bacterial peritonitis (SBP) by culture, smear, and polymorphonuclear (PMN) counts of ascitic fluid. Positive cultures were found in 54 patients. A possible intraabdominal source of infection was apparent in five of them, all with clinically overt peritonitis (secondary peritonitis). No intraabdominal source of infection was identified in the remaining 49. These patients were classified into the following groups: (a) SBP, 27 patients (positive cultures plus PMN counts ± 250 per mm3). Nine of them had no clinical features …