Différences entre versions de « Péritonite bactérienne spontanée »
De médecine.top
Ligne 5 : | Ligne 5 : | ||
* '''Si saignement de varices oesophagiennes''' | * '''Si saignement de varices oesophagiennes''' | ||
** Ceftriaxone/ciprofloxacine durant 7 jours | ** Ceftriaxone/ciprofloxacine durant 7 jours | ||
− | ** Permet d'éviter | + | ** Permet d'éviter les complications d'une translocation bactérienne |
* '''Si patient ascitique à haut risque de PBS''' | * '''Si patient ascitique à haut risque de PBS''' | ||
** Criteria for patients at high risk include an ascitic-fluid total protein level less than 1.5 g/dL (15 g/L) in conjunction with any of the following: serum sodium level less than or equal to 130 mEq/L (130 mmol/L), serum creatinine level greater than or equal to 1.2 mg/dL (106.1 µmol/L), blood urea nitrogen level greater than or equal to 25 mg/dL (8.9 mmol/L), serum bilirubin level greater than or equal to 3 mg/dL (51.3 µmol/L), or Child-Turcotte-Pugh class B or C cirrhosis. | ** Criteria for patients at high risk include an ascitic-fluid total protein level less than 1.5 g/dL (15 g/L) in conjunction with any of the following: serum sodium level less than or equal to 130 mEq/L (130 mmol/L), serum creatinine level greater than or equal to 1.2 mg/dL (106.1 µmol/L), blood urea nitrogen level greater than or equal to 25 mg/dL (8.9 mmol/L), serum bilirubin level greater than or equal to 3 mg/dL (51.3 µmol/L), or Child-Turcotte-Pugh class B or C cirrhosis. |
Version du 20 avril 2020 à 12:21
Diagnostic
- Ponction d'ascite avec numération de leucocytes neutrophiles à ≥250/μl
Prophylaxie
- Si saignement de varices oesophagiennes
- Ceftriaxone/ciprofloxacine durant 7 jours
- Permet d'éviter les complications d'une translocation bactérienne
- Si patient ascitique à haut risque de PBS
- Criteria for patients at high risk include an ascitic-fluid total protein level less than 1.5 g/dL (15 g/L) in conjunction with any of the following: serum sodium level less than or equal to 130 mEq/L (130 mmol/L), serum creatinine level greater than or equal to 1.2 mg/dL (106.1 µmol/L), blood urea nitrogen level greater than or equal to 25 mg/dL (8.9 mmol/L), serum bilirubin level greater than or equal to 3 mg/dL (51.3 µmol/L), or Child-Turcotte-Pugh class B or C cirrhosis.
- Si antécédent de PBS
- Patients who have had a bout of SBP should also receive lifelong antibiotic prophylaxis to reduce the risk for recurrence
Traitement
- Si critères de PBS présents
- If patients have kidney dysfunction, or significant hepatic dysfunction as measured by a serum bilirubin level greater than 4 mg/dL (68 µmol/L), adjunctive therapy with albumin (1.5 g/kg body weight on day 1, as well as 1 g/kg on day 3) should be administered; such treatment has a demonstrated survival benefit.
- Pas de bénéfice démontré à la perfusion d'albumine