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Spontaneous bacterial peritonitis — ACEM Fellowship MCQ

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HardGI/Abdominal emergenciesSpontaneous bacterial peritonitisACEM Fellowship

A 57-year-old man with alcoholic cirrhosis presents to an Auckland ED, triage category 2, with abdominal pain, fever and confusion. Ascitic tap shows neutrophils 620 cells/microlitre, creatinine is 160 micromol/L and bilirubin is 88 micromol/L. What is the most appropriate investigation?

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Correct answer: B — Diagnostic ascitic fluid analysis

Cirrhosis with abdominal pain and fever requires ascitic analysis; neutrophils above 250 cells per microlitre support SBP.

Reference: eTG intra-abdominal infection; hepatology guidelines