Culture negative neutrocytic ascites versus culture positive spontaneous bacterial peritonitis; Is there a Difference; A Multi-Centric Study | ||
| Medical Journal of Viral Hepatitis | ||
| Article 1, Volume 5.3, Issue 3, September 2021, Pages 1-7 PDF (343.08 K) | ||
| Document Type: Original article | ||
| DOI: 10.21608/mjvh.2021.193408 | ||
| Authors | ||
| Ahmed Yassen1; Nasser Mousa* 2; Ahmed Abdel-Razik3; Rasha Mahmoud4; Alaa Habib4; Eman Mousa5; Niveen El-Wakeel6; Aya Fathy7; Sally Abdallah Mostafa8; Narmin Saied9; Muhammad Diasty3; Aya Mousa10; Essam Elmahdi4 | ||
| 1Tropical Medicine Department, Mansoura University, Egypt | ||
| 29 Mohamed Arafa street from Ahmed Maher street, Masoura, Dakahlia Governorate, Egypt | ||
| 3Tropical Medicine Department, Mansoura University, Egypt. | ||
| 4Internal Medicine Department, Mansoura University, Egypt. | ||
| 5Faculty of Dentistry, Mansoura University, Egypt | ||
| 6Medical Microbiology and Immunology, Mansoura University, Egypt. | ||
| 7Public health and community medicine, Mansoura University, Egypt | ||
| 8Medical Biochemistry and Molecular Biology Department, Mansoura University, Egypt. | ||
| 9Clinical Pathology Department, Mansoura University, Egypt. | ||
| 10Faculty of physical therapy, Galala university, Egypt. | ||
| Abstract | ||
| Background: There are two variants of spontaneous bacterial peritonitis (SBP) include, culture negative neutrocytic ascites (CNNA) and culture positive SBP. Some suggested that, the clinical presentation of two variants is nearly similar, however, other reported that, patients with culture positive have a more severe course and higher mortality than CNNA. The aim of this study is to determine the clinical characteristics and predictors of CNNA in comparison to culture positive SBP. Materials and methods: This study included 300 consecutive patients with HCV related cirrhotic ascites. All patients underwent abdominal paracentesis and the ascitic fluid was processed for cell count and culture. Clinical and laboratory parameters of these patients were recorded at index admission.. Results: Out of 300 patients included in the study, 150 patients had SBP. Among the 150 patients with SBP, 100 patients were culture positive SBP (culture positive SBP with ascitic fluid PMNL ≥250 cells/m3) and 50 patients were CNNA (culture negative SBP with ascitic fluid PMNL ≥250 cells/m3). Compared to patients with culture positive SBP, patients with CNNA showed, a significant decrease as regards, fever, prevalence of DM, hepatic encephalopathy, platelets, blood PMNL and ascetic PMNL. Logistic regression analysis demonstrated that, decreased platelets count, blood PMNL and ascetic PMNL were independent predictor factors for CNNA. Conclusion: Patients with CNNA have a lower incidence of fever, prevalence of diabetes mellitus, hepatic encephalopathy, blood PMNL and ascetic PMNL versus culture positive SBP. Independent predictors of culture negative SBP are decreased platelets, blood PMNL and ascetic PMNL. | ||
| Keywords | ||
| Ascitic fluid infections; spontaneous bacterial peritonitis; culture negative neutrocytic ascites; culture positive spontaneous bacterial | ||
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