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205 results

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

Peripheral blood neutrophil, phase contrast microscopy, time lapse, 100x. Olympus CH30

Carlos Martínez Figueroa @CarlosMartnezF7

#neutrophil #Peripheral #blood

hematology #timelapse #PMN

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

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

Peritonitis - Spontaneous vs Secondary vs Peritoneal Dialysis Associated Peritonitis
Spontaneous Bacterial Peritonitis
• Cirrhosis (high SAAG)

) + ascites w/ PMN ... 100 WBC, >50% PMNs

Ascites - Diagnosis and Management Summary
Paracentesis studies: cell count + differential, albumin, protein, culture
• Serum-ascites-albumin-gradient

source • SBP: PMN ... count (WBC x PMN

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