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Spontaneous bacterial peritonitis — ABEM Board MCQ

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ModerateGI/Abdominal emergenciesSpontaneous bacterial peritonitisABEM Board

A 59-year-old man with cirrhosis arrives with abdominal pain and confusion. Triage acuity is ESI 2; T 101.6 F, BP 94/56 mm Hg, HR 116/min. Abdomen is distended with shifting dullness and diffuse tenderness. No peritoneal signs are present. Which of the following is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Perform diagnostic paracentesis and start empiric ceftriaxone

Cirrhotic patients with ascites and infection symptoms need prompt diagnostic paracentesis and empiric antibiotics for suspected SBP.

Reference: AASLD cirrhosis ascites/SBP guidance