الفهرس 
Chronic Liver DiseaseOnly 14 pages are availabe for public view
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Abstract
Ascites remains the commonest of the three major complications of advanced or decompensated cirrhosis (along with hepatic encephalopathy and variceal haemorrhage). SBP is a frequent and severe complication of cirrhotic ascites.
Aeromonas SBP is a fatal disease, and must be included in the differential diagnosis of SBP in patients with advanced liver cirrhosis in endemic areas
In EGYPT, Ascitic fluid infection (AFI) is considered a serious complication in cirrhotic patients and is associated with high morbidity and mortality. To date, SBP due to Aeromonas species in cirrhotic patients has not been evaluated in Egypt.
The aim of the current study was to evaluate the prevalence and asses the clinical presentations of Aeromonas spontaneous bacterial peritonitis in cirrhotic patients in Egypt.
In the current cross sectional study , 60 patients who fulfilled the predesigned inclusion criteria were classified into Group A and Group B and were subjected to ( full history taking, clinical examination, laboratory investigations, abdominal ultrasound and ascetic fluid analysis examination including total leukocyte counts, differential leukocyte count, bacterial culture, Gram staining, and total protein levels).
The cases were adults from 21 years to 70 years mostly males. The age in patients with liver cirrhosis without spontaneous bacterial peritonitis group (51.33±8.35) was older than patients with liver cirrhosis with spontaneous bacterial peritonitis group (48.4±10), but without statistical difference (P>0.05).
Concerning the clinical presentations of the studied groups, abdominal pain, fever, deteriorated consciousness level, and abdominal tenderness were significantly more frequent in-group B representing the major manifestations of SBP (P<0.05).
The laboratory findings, albumin was lower while leukocytes, bilirubin and INR are higher in patients with liver cirrhosis with spontaneous bacterial peritonitis (group B) This may explain that spontaneous bacterial peritonitis may be associated with deterioration of the function of the liver.
Regarding abdominal ultrasound findings, P.V. dilatation and Splenomegaly were more frequent in patients with liver cirrhosis with spontaneous bacterial peritonitis group.
Regarding Child-Pugh Staging, Child C is more common in Group B while Child B is more common in Group A. This also explain that spontaneous bacterial peritonitis may be associated with deterioration of the function of the liver.
In the present study, as expected in the cases of SBP, increasing polymorphonuclear leukocytes and protein concentrations in ascitic fluid were present in patients with liver cirrhosis with spontaneous bacterial peritonitis group.
Gram staining of ascitic fluid determined Gram-negative bacilli in 6 patients of Group B while in 1 patient of Group A correlating with the result of the culture. Leishman film reveals predominance of neutrophils in the ascitic fluid of all patients of group B and predominance of lymphocytes in the ascitic fluid of all patients of group A.
Ascitic fluid culture revealed E coli in 4 patients and Klebsiella in 2 patients in group B patients and Klebsiella in one patient in group A.
However, the results of ascitic fluid cultures in all patients revealed none of the Aeromonas species which clarify that Aeromonas SBP is infrequent in Egypt.