Spontaneous bacterial peritonitis in alcoholic and nonalcoholic cirrhosis in southern Israel (the Negev).

Spontaneous bacterial peritonitis (SBP) is a syndrome diagnosed in 8-18% of hospitalized cirrhotic patients with ascites. The purpose of our study was to investigate the incidence, clinical features, treatment and mortality rate among patients in the Negev (southern Israel) during the years 1982-87. During this period, 21 patients were diagnosed, with a total of 39 episodes of SBP. While the incidence of SBP observed between 1982 and 1985 was 1.8%, this rate rose to 5.1% in 1986-87 (P less than 0.01), almost certainly a result of an increased awareness of the syndrome. Of our patients 13 had a history of nonalcoholic liver disease, while 8 others were diagnosed as having alcoholic liver disease. Nevertheless there were no significant differences regarding the clinical and laboratory features, the bacteria isolated and the outcome, between alcoholic and nonalcoholic patients, except for chills that were reported by 32% of patients with nonalcoholic liver disease and never by patients with alcoholic liver disease (P less than 0.05). We conclude that despite the fact that alcoholic cirrhosis occurs much less frequently in Israel than in Europe or North America, SBP is as frequent among hospitalized cirrhotic patients and demonstrates a similar clinical and bacteriological picture.