الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
One of the most common and serious complications in decompensated cirrhotic patients (DCPs) is bacterial infection. Bacterial infections are known to be important causes of high mortality and morbidity in such patients, although antibiotics have been developed in recent decades .
The most common infections in DCPs are cases of spontaneous bacterial peritonitis (SBP), which account for 40%–70% of cases, followed by urinary tract infections, pneumonia and cellulitis .
When first described, its mortality exceeded 90%, but it has been reduced to _20% with early diagnosis and treatment.
Early diagnosis of SBP is essential in hospitalized patients with liver disease; however, this presents a challenge for clinicians because of the frequent lack of symptoms in the early stages of SBP.
Current guidelines state that culture positivity for a pathogen in ascitic fluid (AF) is the gold standard for the diagnosis of SBP. However, ascites culture has been negative in about 60% of patients with clinical manifestations suggestive of SBP and increased ascites neutrophil count .
A diagnosis of SBP is defined as >250 neutrophils/mm3 in the ascitic fluid not due to secondary bacterial peritonitis (e.g. hemorrhagic ascites, ascites from pancreatitis or tuberculosis peritonitis, ascites secondary to mycobacterial or fungal peritonitis, and ascites secondary to carcinomatosis) culture (monomicrobial).
At present, clinical diagnosis of infected ascitic fluid without paracentesis is not satisfactory and is not recommended. Although paracentesis is generally safe procedure even in patients with coagulopathy, dangerous complications may occur.
Therefore, new studies of early diagnosis, prevention and treatment are needed to improve clinical outcomes. Several potential biomarkers have been proposed in highly cited studies for their ability to diagnose bacterial infections, Many studies have shown that serum procalcitonin (PCT), which is a precursor of calcitonin including 116-aminoacid polypeptide is a sensitive biomarker that can be used to monitor bacterial infections, and measurements of PCT levels may guide the clinical use of antibiotics .
However, the diagnostic value of serum PCT levels in DCPs with infections especially SBP, remains unclear, several new studies of PCT have been published and our knowledge of PCT is still developing.
This study was conducted on 45 patients with decompensated chronic liver disease and ascites with and without spontaneous bacterial peritonitis admitted to Internal Medicine Department in Menoufiya University Hospital.
Patients were classified into two groups.
group I: Included 15 patients with cirrhotic ascites without spontaneous bacterial peritonitis (non SBP) which 13 was female and 2 male.
group II: Included 30 patients with cirrhotic ascites with spontaneous bacterial peritonitis (SBP) which 20 female and 10males.