• Thiago José Buer Reginato, Marcelo José Andrade Oliveira, Luiz César Moreira, Antonieta Lamanna, Milena Marques Pagliarelli Acencio, and Leila Antonangelo.
• Clinical Laboratory Division, Department of Pathology, LIM 03, Hospital das Clínicas-HC, Faculdade de Medicina da Universidade de São Paulo-FMUSP, São Paulo, Brazil.
• Sao Paulo Med J. 2011 Jan 1; 129 (5): 315319315-9.

Context And ObjectiveSpontaneous bacterial peritonitis (SBP) is a complication of ascites, especially in cirrhosis. Ascitic fluid with 250 or more neutrophils/mm³ is an acceptable criterion for diagnosis, even when bacterial fluid cultures are negative. The aims here were to estimate SBP frequency among emergency room patients based on cellular criteria and evaluate the biochemical profile of these fluids.Design And SettingRetrospective study at a public tertiary hospital.MethodsLaboratory records of patients with ascites attended in emergency rooms between November 2001 and November 2006, from whom ascitic fluid samples were sent to the laboratory due to suspected SBP, were evaluated. The 691 samples included were divided into group A (presumed SBP: ≥ 250 neutrophils/mm³; n = 219; 31.7%) and group B (no presumed SBP: < 250 neutrophils/mm³; n = 472; 68.3%). Patients' sex and age; ascitic fluid characteristics (numbers of neutrophils, leukocytes and nucleated cells); bacteriological characteristics; and protein, lactate dehydrogenase, adenosine deaminase and glucose concentrations were evaluated.ResultsAmong group A cultured samples, 63 (33.8%) had positive bacterial cultures with growth of pathogens commonly associated with SBP. In total, the group A samples showed higher lactate dehydrogenase levels than seen in the group B samples. The latter presented predominance of lymphocytes and macrophages.ConclusionAmong the ascitic fluid samples with clinically suspected SBP, 31.7% fulfilled the cellular diagnostic criteria. Positive bacterial isolation was found in 33.8% of the cultured samples from the presumed SBP group.

24 keywords...

hide…