Spontaneous bacterial peritonitis.

Spontaneous bacterial peritonitis should be considered in the evaluation of any patient with acute abdominal complaints, especially in the presence of preexistent ascites. Paracentesis is indicated in all suspected cases of spontaneous peritonitis in order to obtain necessary studies, including microbial cultures. Broad-spectrum antibiotic coverage has become necessary because of the increasing incidence of gram-negative isolates. Ascitic pH and lactate may provide accurate information in the evaluation of spontaneous peritonitis, although increased clinical awareness remains the key to proper diagnosis.