title: Spontaneous bacterial peritonitis due to Brucella Melitensis in a cirrhotic patient.
abstract: Spontaneous bacterial peritonitis is a well-known entity, with a reported incidence of 15-20% in advanced cirrhotic patients. Escherichia coli and Klebsiella pneumoniae are the most common causes of spontaneous bacterial peritonitis; Brucella is extremely rare. We aimed to present one case of such a rare condition in a cirrhotic patient who also had hepatocellular carcinoma. Routine laboratory tests, abdominal ultrasonography and peritoneal fluid examinations were studied in a cirrhotic patient with ascites. Peritoneal fluid white blood cell count was 1300/mm3, with lymphocyte predominance (80%). Peritoneal fluid and blood culture both yielded Brucella melitensis. The patient also had a mass in the right lobe of the liver confirmed as hepatocellular carcinoma by biopsy. Brucella should be suspected as a cause of spontaneous bacterial peritonitis in cirrhotic patients with no response to standard spontaneous bacterial peritonitis treatments and with immunodeficiency such as hepatocellular carcinoma.
authors.affiliation: Division of Gastroenterology, Medical Faculty, Sütçü Imam University, Kahramanmaraş, Turkey. bkantarceken@ksu.edu.tr
authors.forename: Bülent
authors.initials: B
authors.lastname: Kantarçeken
authors.forename: M Murat
authors.initials: MM
authors.lastname: Harputluoğlu
authors.forename: Yaşar
authors.initials: Y
authors.lastname: Bayindir
authors.forename: Mehmet Refik
authors.initials: MR
authors.lastname: Bayraktar
authors.forename: Murat
authors.initials: M
authors.lastname: Aladağ
authors.forename: Fatih
authors.initials: F
authors.lastname: Hilmioğlu
mesh_terms: D000368:Aged; D001202:Ascitic Fluid / Q000382:microbiology; D001706:Biopsy; D017347:Brucella melitensis / Q000302:isolation & purification*; D002006:Brucellosis / Q000150:complications / Q000382:microbiology*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000473:pathology; D017809:Fatal Outcome; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000473:pathology; D008113:Liver Neoplasms / Q000150:complications / Q000473:pathology; D008297:Male; D010538:Peritonitis / Q000150:complications / Q000382:microbiology*