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Chonnam Med J. 2007 Aug;43(2):110-115. Korean. Original Article.
Lim SR , Kim YJ , Ryang DY , Chung KM , Jeong HK , Kim HI , Jun CH , Lee WS , Park CH , Kim HS , Choi SK , Rew JS .
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Chonnam National Univercity Reserch Institute of Medical Sciences, Gwangju, Korea.

Spontaneous bacterial peritonitis (SBP) is a serious and fatal complication of liver cirrhosis, even though early diagnosis and more effective antibiotic treatment. The aim of this study is to evaluate the recent clinical characteristics of patients with SBP admitted in Chonnam National University Hospital. One hundred thirty episodes in 113 patients of SBP occuring between 2000 and 2005 were retrospectively analyzed. Clinical characteristics and laboratory findings were compared between survival and expired group. The etiology of cirrhosis was hepatitis B virus (63.1%), alcohol (26.2%). Abdominal pain (72.3%) and fever (53.8%) were common symptoms. Child-Pugh class C was common (76.9%). The positive rate of bacterial culture was 23% in ascitic fluid or blood, and Escherichia coli was the most common microorganism. The mortality rate of patients with SBP was 23.8%. The causes of death were renal failure (41.9%), progressive liver failure (29%), gastrointestinal bleeding (16.1%). Nosocomial infection was more common in expired group (p=0.001, 0.004). The count of WBC (p=0.006), polymorphonuclear leukocyte (p=0.009), platelet (p=0.022), and serum bilirubin (p=0.003), BUN (p=0.002), creatinine (p=0.002) and protein of ascitic fluid (p=0.007) in expired group were higher than those of survival group. In conclusion, The patients with SBP associated with nosocomial infection, high WBC count and serum bilirubin, and renal impairment should be treated carefully and close follow-up of renal and liver failure is required.

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