Spontaneous bacterial peritonitis from Salmonella: an unusual bacterium with unusual presentation.
Spontaneous bacterial peritonitis (SBP) is a common cause of morbidity and mortality in patients with advanced cirrhosis and portal hypertension. While gram-negative rods and Enterococcus species are the common offending organisms, Salmonella has also been recognized as a rare and atypical offending organism. Atypical features of Salmonella SBP include both its occurrence in cirrhotic patients with immunosuppressive state and its lack of typical neutroascitic response. Diagnosis is often delayed as it requires confirmation from ascitic fluid culture. We report a case of Salmonella SBP occurring in a patient with decompensated cryptogenic cirrhosis with concurrent low-grade non-Hodgkin lymphoma and prior treatment with rituximab. Physicians should be aware of the atypical presentation, especially in cirrhotic patients who are immunosuppressed.
Rajekar
Harshal
H
Asian Center for Liver Diseases and Transplantation, Gleneagles Hospital Annexe Block #02-37, 6A Napier Road, Singapore, Singapore, 258500.
Wai
Chun-Tao
CT
Lee
Kang-Hoe
KH
Wong
Sin-Yew
SY
Tan
Kai-Chah
KC