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Celiac disease — RCPSC IM MCQ

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HardGastroenterology/HepatologyCeliac diseaseRCPSC IM

A patient with cirrhosis and ascites develops fever, diffuse abdominal discomfort and worsening kidney function. Diagnostic paracentesis shows 420 neutrophils/mm³. What is the most appropriate immediate treatment?

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Correct answer: B — Give IV antibiotics for spontaneous bacterial peritonitis

The best answer is “Give IV antibiotics for spontaneous bacterial peritonitis”. An ascitic neutrophil count of at least 250/mm³ establishes presumptive spontaneous bacterial peritonitis and mandates prompt empiric antibiotics; albumin is considered according to renal and biochemical risk. Culture may be negative and must not delay therapy, while diuresis, drainage alone and lactulose do not treat infection.

Reference: Cirrhosis Care, treatment-provider resources: https://cirrhosiscare.ca/treatment-provider/