How do you diagnose spontaneous bacterial peritonitis?
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Ascitic fluid containing >500 polymorphonuclear leukocytes (PMNs) has the strongest test characteristics, but to minimize false-negative results, a PMN count >250 cells/μL is recommended as the diagnostic cut-point. (SOR: A, based on multiple, consistent diagnostic cohort studies.) Ascitic fluid lactoferrin has recently been utilized as a rapid bedside test, but needs further investigation. (SOR: B, based on a single diagnostic cohort study.) Leukocyte esterase testing has an unsatisfactory sensitivity. (SOR: B, based on a multicenter diagnostic cohort study.)
Evidence Based Practice 14(10): 08-09.