Spontaneous bacterial peritonitis causes
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Differentiating Spontaneous bacterial peritonitis from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2];Luke Rusowicz-Orazem, B.S.;Shivani Chaparala M.B.B.S [3]
Overview
- Spontaneous bacterial peritonitis is often a blood-borne infection caused by Enteric organisms-70% (Mono-microbial in 90%).
- Aerobic gram-negative bacteria like Escherichia coli account for half of the cases.
- Gram-positive cocci Streptococcussp in 20% cases with enterococcus accounting for 5% of the cases
- Staphylococcus aureus and Streptococcus salivarius are less frequent causes.
- Poly-microbial infection is mostly because of Iatrogenic cause (more likely associated with abdominal paracentesis) or intra-abdominal source of infection.
Causes
Common Causes
- Spontaneous bacterial peritonitis is often a blood-borne infection caused by Enteric organisms-70% (Mono-microbial in 90%).
- Aerobic gram-negative bacteria like Escherichia coli account for half of the cases.
- Gram-positive cocci Streptococcussp in 20% cases with enterococcus accounting for 5% of the cases
- Staphylococcus aureus and Streptococcus salivarius are less frequent causes.
- Poly-microbial infection is mostly because of Iatrogenic cause (more likely associated with abdominal paracentesis) or intra-abdominal source of infection.
A variety of abnormalities contributing to the infection were identified which include:
- GI bleeding
- ↑Colonization of the small bowel with prominent bacterial translocation
- ↓Opsonic activity in blood and ascitic fluid
- Impaired Compliment
- Leukocyte dysfunction
- ↓Antibodies
- ↑Immunosuppressive cytokines, endotoxin, TNF
Causes by Organ System
| Cardiovascular | Cardiogenic ascites |
| Chemical/Poisoning | No underlying causes |
| Dental | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | Proton Pump Inhibitors and Beta Adrenergic Antagonists |
| Ear Nose Throat | No underlying causes |
| Endocrine | No underlying causes |
| Environmental | No underlying causes |
| Gastroenterologic | Ascites, Chronic liver disease, Cirrhosis , Intrahepatic blood shunting , Portal hypertension |
| Genetic | No underlying causes |
| Hematologic | No underlying causes |
| Iatrogenic | Continuous ambulatory peritoneal dialysis |
| Infectious Disease | Acinetobacter infections, Actinomyces infections , Aerococcus urinae , Aeromonas hydrophila, Arcanobacterium haemolyticum , Bacteroides fragilis, Bordetella bronchiseptica, Brucella infection, Candida infection, Citrobacter freundii, Coccidioides immitis , Cryptococcus neoformans , Defective ascite bactericidal activity, Enterococcus casseliflavus , Enterococcus faecalis , Enterococcus gallinarum , Enterococcus hirae , Escherichia coli , Gemella morbilorum , Haemophilus influenzae, Haemophilus parainfluenzae , Klebsiella pneumonia, Leclercia adecarboxylata , Leminorella grimontii , Listeria monocytogenes, Neisseria meningitidis , Ochrobactrum anthropi , Plesiomonas shigelloides, Proteus infections, Pseudomonas aeruginosa , Salmonella paratyphi a , Salmonella typhimurium , Staphylococcus aureus , Streptococcus pneumoniae, Streptococcus salivarius , Vibrio vulnificus, Viridans group streptococci Mycobacterium Tuberculosis |
| Musculoskeletal/Orthopedic | No underlying causes |
| Neurologic | No underlying causes |
| Nutritional/Metabolic | Malnutrition |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | No underlying causes |
| Ophthalmologic | No underlying causes |
| Overdose/Toxicity | Cirrhosis |
| Psychiatric | No underlying causes |
| Pulmonary | No underlying causes |
| Renal/Electrolyte | Nephrotic syndrome |
| Rheumatology/Immunology/Allergy | No underlying causes |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Miscellaneous | Malignant ascites |
Causes in Alphabetical Order
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