Spontaneous bacterial peritonitis causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shivani Chaparala M.B.B.S [2]
Overview
Spontaneous bacterial peritonitis is a blood-borne infection caused by enteric organisms in 70% of cases (mono-microbial origin in 90% of cases). Aerobic gram-negative bacteria like Escherichia coli account for half of the cases. Gram-positive cocci Streptococcus species in 20% cases and enterococcus accounting for 5% of the cases. Staphylococcus aureus and Streptococcus salivarius are less frequent causes. Poly-microbial infection is mostly iatrogenic (more likely associated with abdominal paracentesis) or intra-abdominal source of infection. The cause of SBP is not definitively established, but is believed to involve hematogenous spread of organisms in patients with liveradiseasend altered portal circulation rn adults, spontaneous bacterial peritonitis occurs m conjunction with cirrhosis of the liver and portal hypertension (.
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 Streptococcus speciesaccount for 20% cases and enterococcus accounts for 5% of the cases.
- Staphylococcus aureus and Streptococcus salivarius are less frequent causes.
- Poly-microbial infection is mostly iatrogenic (associated with abdominal paracentesis) or intra-abdominal source of infection.
Factors contributing to the infection include:
- GI bleeding
- Increased colonization of the small bowel with prominent bacterial translocation
- Decreased opsonic activity in blood and ascitic fluid
- Impaired Complement
- Leukocyte dysfunction
- Reduced Antibodies
- Increased immunosuppressive cytokines, endotoxin, TNF