Spontaneous ascites infection in patients with ascites secondary to cirrhosis

ABSTRACT SPONTANEOUS ASCITES INFECTION IN PATIENTS WITH ASCITES SECONDARY TO CIRRHOSIS Spontaneous ascites infection (SAI) is a frequent and life threatening complication in cirrhotic patients which occurs as the result of the defects in various components of the body defense mechanisms. The aim of this trial was to assess the frequency of SAI during the course of cirrhosis, and to detect the pathogenic microorganisms and biochemical features of ascitic fluid, also to find out the relationship between ascitic fluid findings and functional capacity of liver and to determine the prognosis of cirrhotic patients. 168 men and 62 women total 230 cirrhotic patients (mean age 54.6±12.8 years) with ascites hospitalized at Çukurova University Intensive Care Unit and Gastroenterology Ward were included in this study. Patients were diagnosed by clinical findings, biochemical, ultrasonographical and histopathological examinations. Majority of the cases were secondary to chronic viral hepatitis and chronic alcohol abuse and were classified in Child C stage. The most common manifestations were abdominal pain, abdominal tenderness, and fever. The most common encountered microorganisms were gram-negative bacilli with predominantly E.coli. In 35.7% of these patients, the same microorganisms were isolated in blood samples as well as ascites fluid which were cultured simultaneously. SAI was found in 25.7% of cirrhotic patients. Neutrocytic ascites which was designated with negative bacterial culture was observed most frequently while spontaneous bacterial peritonitis was found least in these cases. The mortality rate of our patients with SAI was high during hospitalization and outpatient period. The cases had low relapse rate during hospitalization, but it was increased during one year follow up period. We observed that the infection risk was increased in contrast to the albumin content of ascites fluid either it was not found statistically significant. Our findings was suggested that ascitic fluid leukocyte count (especially neutrocyte) was the most reliable parameter for the diagnosis of SAI. rvKey words: Cirrhosis, spontaneous ascites infection, spontaneous bacterial peritonitis, culture-negative neutrocytic ascites, monobacterial nonneutrocytic bacterascites.