Spontaneous Bacterial Peritonitis (SBP) Diagnostic Criteria

Spontaneous bacterial peritonitis (SBP) is an infection of ascitic fluid that occurs without an intra-abdominal surgically treatable source (i.e., not due to perforation, abscess, etc.). It most commonly affects patients with cirrhosis and ascites and can present with fever, abdominal pain, encephalopathy, renal dysfunction, or even no symptoms.

Gastroenterology

SBP Diagnostic Criteria Calculator

Calculates ascitic fluid PMN count and applies an optional traumatic-tap correction. A corrected ascitic PMN count of ≥250 cells/mm³ supports a presumptive diagnosis of spontaneous bacterial peritonitis (SBP).

Ascitic fluid PMN count

Enter either the laboratory-reported absolute PMN count or calculate it from ascitic nucleated cells and neutrophil percentage.

Option A: Absolute PMN count

Use this when the ascitic fluid PMN count is already reported by the laboratory.

Option B: Calculate PMN count

Used only when Option A is blank.

Formula: PMN = nucleated cells × (PMN percentage ÷ 100).

Traumatic tap correction

Consider this only for a traumatic or bloody paracentesis, typically when the ascitic RBC count is greater than 10,000 cells/mm³.

Ascitic fluid culture

Optional. Culture results help classify neutrocytic ascites and bacterascites but do not replace clinical assessment.

Clinical reminder: SBP requires the absence of an intra-abdominal surgically treatable source. Polymicrobial growth should prompt assessment for secondary bacterial peritonitis.

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