The Diagnostic Value of Leukocyte Esterase Reagent Dip-stick in Spontaneous Bacterial Peritonitis Diagnosis in Patients with Liver Cirrhosis | ||
| Suez Canal University Medical Journal | ||
| Article 7, Volume 22, Issue 1, March 2019, Pages 56-63 PDF (400.22 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/scumj.2019.49262 | ||
| Authors | ||
| Amal Gad* 1; Nader El-Nemr2; Mohamed Saad3 | ||
| 1Department of Internal Medicine, Faculty of Medicine, Suez Canal University, Egypt | ||
| 2Department of Endemic and Infectious Diseases, Faculty of Medicine, Suez Canal University, Egypt | ||
| 3Department of Internal Medicine, Ismailia General Hospital, Egypt | ||
| Abstract | ||
| Background: Spontaneous bacterial peritonitis (SBP) is a serious complication of advanced liver cirrhosis which requires rapid diagnosis for the initiation of proper antibiotic therapy. Manual examination of ascetic fluid is a rather time-consuming procedure. The leukocyte esterase (LE) reagent dipstick is based on the esterase activity of activated granulocytes which reacts with an ester‑releasing hydroxyphenylpyrrole causing a color change in the azo dye of reagent strip. Aim: the aim of this study was to evaluate the diagnostic value of leukocyte esterase reagent dipstick in SBP diagnosis in patients with liver cirrhosis attending Suez Canal University Hospital. Methods: ascetic fluid cell count using the counting chamber method was compared to Leucocyte Esterase strip rapid test in two groups of patients (65 ABP vs 65 non-SBP). The strips were read in 120 seconds using colorimetric 5-grade scale (from 0 to 4). The grades (0-2) were considered a negative test while grades (3-4) were considered a positive one. Results: Comparison of the SBP +ve and -ve groups showed a sensitivity of LE strips of (82%) with a high specificity (94 %), PPV (93 %) and NPV (84 %) for the diagnosis of SBP. A good correlation between the LE strip color grade and the ascetic fluid PMNL cell count number (P<0.05) Conclusion: the leukocyte esterase reagent dipstick test is a rather specific, rapid, inexpensive and simple bedside method for diagnosis of SBP method for. A negative LE test result excludes SBP with a high accuracy. | ||
| Keywords | ||
| Leukocyte Esterase; Spontaneous Bacterial Peritonitis; Liver cirrhosis | ||
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