الفهرس 
Chapter (1): Spontaneous bacterial peritonitisOnly 14 pages are availabe for public view
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Abstract
Spontaneous bacterial peritonitis (SBP) is a serious complication of liver cirrhosis and is defined as infected ascites in the absence of any recognizable secondary cause of infection. One of the possible mechanisms of developing spontaneous bacterial peritonitis is bacterial translocation.
The severity of underlying liver dysfunction is predictive of developing SBP; moreover, renal impairment and infections caused by multidrug-resistant (MDR) organisms are associated with a fatal prognosis of spontaneous bacterial peritonitis.
Interleukin-17 is a pro-inflammatory cytokine that contributes to host defense against extracellular pathogens. IL 17-A can mobilize, recruit, and activate neutrophils, leading to massive tissue inflammation, and promoting the progression of autoimmune disease. Furthermore, serum IL-17 levels are increased and serve as a marker of the severity of the acute hepatic injury
The study aims to determine the diagnostic value of serum and ascetic interleukin -17 in spontaneous bacterial peritonitis detection in Egyptian patients with HCV-related liver cirrhosis.
To elucidate this aim 60 Patients were classified into two groups:
• group Ⅰ: including 30 hepatic patients post hepatitis C cirrhotic with ascites without spontaneous bacterial peritonitis.
• group ⅠⅠ: including 30 hepatic patients post hepatitis C cirrhotic with ascites and spontaneous bacterial peritonitis.
Summary of results:
-In the present study, MELD and MELD-NA scores were significantly improved after treatment of SBP.
-B.Urea, CRP, and serum IL17 were significantly decreased after treatment of SBP.
-Total leucocyte count in ascitic fluid and mean ascitic IL17 were significantly decreased after treatment of SBP.
- Platelet count and eGFR were significantly increased after treatment of SBP.
- Child-Pugh class was significantly improved after treatment of SBP.
- Ascetic interleukin 17 and serum IL17 were significantly decreased after treatment of SBP.
-Serum interleukin 17 had excellent diagnostic performance to differentiate spontaneous bacterial peritonitis from non-SBP group with a sensitivity of 91.54% and specificity of 96.45%.
Also, Ascitic interleukin 17 had excellent diagnostic performance to discriminate between patients with spontaneous bacterial peritonitis from non-SBP group with a sensitivity of 94.85% and specificity of 95.69%.