醫(yī)學(xué)生物ppt】般內(nèi)科病例討論-資料下載頁
2025-01-04 04:34本頁面
【正文】 – Rebound tenderness ?? Cirrhotic p’t with ascites, + any clinical s/s ?? Dx pracentesis to exclude SBP 業(yè)精于勤荒于嬉 行成于思毀于隨 → 【醫(yī)學(xué)生物 PPT，歡迎收藏分享】網(wǎng)友 25 DDx of Bacterial peritonitis Type Ascites cell count/mm3 Ascites cultures Sterile 250 polys Spontaneous bacterial peritonitis (SBP) 250 polys one ansim Culture –negative neutrocytic ascites 250 polys Nonneutrocytic bacterascites 250 polys one ansim Secondary 250 polys Polymicrobial Peritoneal dialysisassociated 100 with poly predom. 業(yè)精于勤荒于嬉 行成于思毀于隨 → 【醫(yī)學(xué)生物 PPT，歡迎收藏分享】網(wǎng)友 26 ? Risk factors – Ascites fluid total protein – Serum bilirubin – Prior SBP ? Pathogens – 70% GNR: E. coli, klebsiella – 30% GPC: S. pneumococcus ,other streptococci, Enterococcus Spontaneous bacterial peritonitis 業(yè)精于勤荒于嬉 行成于思毀于隨 → 【醫(yī)學(xué)生物 PPT，歡迎收藏分享】網(wǎng)友 27 ? Treatment – Ceftriaxone 2g IV qd x 5 days – Cefotaxime 2gm IV q8h x 5 days – IV albumin , 1g/kg on day 3 results in survival benefit (NEJM 1999。341:403) ? Prophylaxis – Hx of SBP – Current GI Bleeding – AFTP– Norfloxacin 400mg PO qd or Bactrim DS qd Spontaneous bacterial peritonitis 業(yè)精于勤荒于嬉 行成于思毀于隨 → 【醫(yī)學(xué)生物 PPT，歡迎收藏分享】網(wǎng)友 28 The End
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