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
