Back to Search
Start Over
Combined spontaneous bacterial empyema and peritonitis in cirrhotic patients with ascites and hepatic hydrothorax.
- Source :
-
Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology [Arab J Gastroenterol] 2017 Jun; Vol. 18 (2), pp. 104-107. Date of Electronic Publication: 2017 Jun 01. - Publication Year :
- 2017
-
Abstract
- Background and Study Aims: Spontaneous bacterial empyema (SBEM) is an underestimated condition in patients with ascites and hepatic hydrothorax with a high mortality. This study aimed to find whether spontaneous bacterial peritonitis (SBP) is a prerequisite for SBEM.<br />Patients and Methods: 3000 HCV-related cirrhotic patients with ascites and hydrothorax were screened for the presence of SBP (ascitic fluid neutrophils >250/mm <superscript>3</superscript> ) and SBEM (positive pleural fluid culture and neutrophils >250/mm <superscript>3</superscript> or negative pleural fluid culture and neutrophils >500/mm <superscript>3</superscript> with no evidence of pneumonia/parapneumonic effusion on chest radiograph or CT).<br />Results: The prevalence of SBEM in cirrhotic patients was 1.2% (36/3000) unlike SBP (1.6%; 48/3000). SBEM was detected in 51.4% of the patients with hepatic hydrothorax (36/70). A total of 70 patients had concomitant ascites and hydrothorax, namely SBP (n=17), SBEM (n=5), and dual SBP and SBEM (n=31), whereas 17 patients had sterile concomitant ascites and hydrothorax. Age, sex, liver function, kidney function tests, complete blood count, INR, MELD, MELD-Na, blood chemistry, and culture/sensitivity for ascitic and pleural fluid were statistically not different (p>0.05) between SBP and dual SBP and SBEM patients. Escherichia coli and Klebsiella pneumoniae were detected in the culture. From univariate analysis, no predictors of dual SBP and SBEM were detected.<br />Conclusion: SBEM is a part of SBP in cirrhotic patients with ascites and hydrothorax.<br /> (Copyright © 2017 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Aged
Anti-Bacterial Agents therapeutic use
Ascites microbiology
Cefotaxime therapeutic use
Egypt epidemiology
Empyema drug therapy
Empyema microbiology
Escherichia coli
Escherichia coli Infections complications
Female
Humans
Hydrothorax microbiology
Klebsiella Infections complications
Klebsiella pneumoniae
Male
Middle Aged
Peritonitis drug therapy
Peritonitis microbiology
Prevalence
Ascites etiology
Empyema epidemiology
Hydrothorax etiology
Liver Cirrhosis complications
Peritonitis epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 2090-2387
- Volume :
- 18
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 28579346
- Full Text :
- https://doi.org/10.1016/j.ajg.2017.05.010