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Spontaneous bacterial peritonitis — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Spontaneous bacterial peritonitisUSMLE Step 3

A 59-year-old man with cirrhosis and tense ascites has fever and mild confusion. Paracentesis shows ascitic neutrophil count 420/mm3. Culture results are pending. Which of the following is the most likely diagnosis?

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Correct answer: A — Spontaneous bacterial peritonitis

An ascitic polymorphonuclear cell count of at least 250/mm3 in cirrhosis supports spontaneous bacterial peritonitis and requires treatment.

Reference: AASLD cirrhosis ascites guidance