What is PMN in ascitic fluid?
Polymorphonuclear (PMN) cell count in the ascitic fluid is essential for the diagnosis and management of spontaneous bacterial peritonitis (SBP). To date, PMN cell count is routinely performed by traditional manual counting. However, this method is time-consuming, costly, and not always timely available.
What is the PMN threshold for the diagnosis of SBP?
Therefore, the diagnosis of SBP is confirmed based on a PMN count in the ascites of >250 cells/mm3 in the absence of an intra-abdominal and surgically treatable source of infection.
How do you calculate PMN?
The PMN count is calculated by multiplying the white cells/mm3 by the percentage of neutrophils in the differential. In a bloody sample, which contains a high concentration of red blood cells, the PMN count must be corrected: 1 PMN is subtracted from the absolute PMN count for every 250 red cells/mm3 in the sample.
What is positive SBP?
Spontaneous bacterial peritonitis (SBP) is defined as an ascitic fluid infection without an evident intraabdominal surgically-treatable source; it primarily occurs in patients with advanced cirrhosis [1,2].
Who gets SBP prophylaxis?
Antibiotic prophylaxis for SBP should be given to persons with cirrhosis with a prior history of SBP or acute gastrointestinal bleeding, and should be considered in persons without a history of SBP who have renal and/or hepatic dysfunction—if the ascitic fluid total protein is less than 1.5 g/dL.
Is SBP fatal?
Spontaneous bacterial peritonitis (SBP) is a common and often fatal complication occurring in cirrhotic patients with ascites. It is defined as an infection of the ascitic fluid in the absence of any obvious intra-abdominal source.
What is a high PMN count in SBP?
PMNs > 250 cells is diagnostic of SBP. If there are greater than 100k RBCs, you should correct for them: for every 250 RBCs, subtract 1 PMN A positive ascitic bacterial culture is diagnostic and should be treated regardless of PMN count.
How do you calculate SBP with a diff?
Obtain cell count with diff. Calculate the PMNs: total nucleated cells x % neutrophils. PMNs > 250 cells is diagnostic of SBP. If there are greater than 100k RBCs, you should correct for them: for every 250 RBCs, subtract 1 PMN
How do you calculate SBP from cell count?
Obtain cell count with diff. Calculate the PMNs: total nucleated cells x percent neutrophils. PMNs > 250 cells is diagnostic of SBP. If there are greater than 100k RBCs, you should correct for them: for every 250 RBCs, subtract 1 PMN For patients with ascites on peritoneal dialysis, the cutoff is 100 PMNs to diagnose SBP.
What does SBP of all three components uncommon mean?
Presence of all three components uncommon SBP is a difficult diagnosis to make because presentations are variable. Consider a diagnostic paracentesis in all patients presenting to the ED with ascites from cirrhosis