Ascitic Fluid Criteria for Bacterial Peritonitis

What the result means

250 or more

Neutrocytic ascites. With one organism grown this is spontaneous bacterial peritonitis; with no growth it is culture-negative neutrocytic ascites and is managed the same way.

Under 250, one organism

Bacterascites. The published response is to repeat the tap rather than to dismiss the growth.

Under 250, no growth

The neutrophil criterion is not met.

Correct for blood first

Subtract one neutrophil for every 250 red cells. A bloody tap carries neutrophils in with the blood and can cross 250 on the blood alone.

Neutrophils, not the total

A total nucleated count of 500 with 30 percent neutrophils is 150, under the line.

More than one organism

Points away from a spontaneous infection and toward a perforated or inflamed viscus, which is a surgical question.

Albumin figures

The trial gave 1.5 g per kg within six hours and 1 g per kg on day 3 where the creatinine was above 1, the urea nitrogen above 30 or the bilirubin above 4 mg/dL.