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Spontaneous Bacterial Peritonitis DIAGNOSTICS Paracentesis: • Calculate absolute PMN count (total WBC x PMN %) • Correct
Calculate absolute PMN ... count (total WBC x PMN ... %) • Correct PMN ... RBCs (subtract 1 PMN ... ascites (CNNA) = PMN
Peritonitis - Spontaneous vs Secondary vs Peritoneal Dialysis Associated Peritonitis Spontaneous Bacterial Peritonitis • Cirrhosis (high SAAG)
) + ascites w/ PMN ... 100 WBC, >50% PMNs
Peripheral blood neutrophil, phase contrast microscopy, time lapse, 100x. Olympus CH30 Carlos Martínez Figueroa @CarlosMartnezF7 #neutrophil #Peripheral #blood
hematology #timelapse #PMN
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 Spontaneous Bacterial Peritonitis Clinical • Fever • Chills • Abdominal pain Diagnosis
Diagnosis • PMN
Fig. 1 Pathophysiology of septic myocardial dysfunction. IL interleukin, iNOS induced nitric oxide synthase, PMN polymorphonuclear
oxide synthase, PMN
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 Arthrocentesis - Joint Fluid Analysis Effusion Characteristics (Color, Clarity, WCC, PMN, Crystals, Bacteria) by Disease Process: OA,
Clarity, WCC, PMN
Ascites - Differential Diagnosis and Workup Algorithm • Perform paracentesis: • Cell count and diff • Total
ascites WBC and PMN
Spontaneous Bacterial Peritonitis (SBP) - Diagnosis and Management Ascites PMN > 250/mm3 ? Nosocomial or hospital acquired. Recent
Management Ascites PMN ... response - ↓ PMN
Synovial Fluid Analysis: Findings (COLOR TRANSPARENCY VISCOSITY WBC COUNT (PER MM3) PMN CELL COUNT (%) GRAM STAIN CULTURE PCR TEST CRYSTALS) By Condition (Normal Noninflammatory Inflammatory:
COUNT (PER MM3) PMN
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 Characteristics of Selected Pneumonias Streptococcus pneumoniae (pneumococcus). Gram-positive diplococci. Haemophilus influenzae. Pleomorphic gram-negative coccobacilli. Staphylococcus aureus. Plump
PMNs and monocytes ... Few PMNs; no bacteria
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