Peritonitis - Spontaneous vs Secondary vs Peritoneal Dialysis Associated Peritonitis

Spontaneous Bacterial Peritonitis

 • Cirrhosis (high SAAG) + ascites w/ PMN > 250

 • Treatment: 3rd generation cephalosporin + albumin

Secondary Bacterial Peritonitis

 • Secondary to perforation or decreased GI tract integrity

 • Runyon's Criteria: Ascitic fluid protein > 1 g/dL, glucose < 50, LDH ULN for serum

Peritoneal Dialysis Associated Peritonitis

 • Criteria (at least 2): 1) Clinical Features (abd pain, cloudy effluent) 2) WBC > 100 WBC, >50% PMNs 3) Positive Culture

 • Treatment: Intraperitoneal vancomycin + gram(-) coverage, catheter removal



Dr. Ann Marie Kumfer @AnnKumfer



#Peritonitis #Spontaneous #Secondary #Peritoneal #diagnosis #differential #ascites