skip to main content

Spontaneous bacterial peritonitis — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardGastroenterology and hepatologySpontaneous bacterial peritonitisSCE Acute Medicine

A patient with cirrhosis has fever, ascitic neutrophils 420/mm3, creatinine 158 micromol/L and bilirubin 66 micromol/L. What is the next step?

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

Reveal the answer and explanation

Correct answer: C — Give intravenous antibiotics and albumin for SBP

The best answer is “Give intravenous antibiotics and albumin for SBP”. This is correct because an ascitic neutrophil count at least 250/mm3 establishes the treatment threshold. Prompt antibiotics are essential, and albumin reduces renal failure and mortality in higher-risk patients. Culture negativity is common, while drainage, diuretic escalation and albumin without antibiotics do not eradicate infection.

Reference: British Society of Gastroenterology decompensated-cirrhosis care bundle: https://www.bsg.org.uk/clinical-resource/new-decompensated-cirrhosis-admission-care-bundle