Clinical Overview
Spontaneous bacterial peritonitis is a serious infection of ascitic fluid. It usually affects people with cirrhosis and ascites. Fast recognition matters because symptoms can be mild. Fever, abdominal pain, confusion, vomiting, renal decline, or shock may appear. Some patients show few signs, so fluid testing remains central.
What the Tool Checks
This calculator organizes common ascitic fluid findings. It estimates the absolute polymorphonuclear cell count from total white cells and neutrophil percentage. It can also accept a direct PMN value from a laboratory report. When the sample is bloody, the tool applies a red cell correction. The corrected count is then compared with the usual 250 cells per cubic millimeter threshold.
Culture Context
Culture results add context. A positive monomicrobial culture with a high PMN supports SBP. A negative culture with a high PMN may still represent culture negative neutrocytic ascites. A positive culture with a low PMN may suggest bacterascites, especially when symptoms are absent. Polymicrobial growth or strong secondary source clues should prompt urgent review for secondary peritonitis.
Albumin Math
The tool also estimates albumin amounts by body weight. These values are informational. They help document common day one and day three dose calculations. Actual therapy depends on renal function, bilirubin, local resistance patterns, allergies, severity, and clinician judgment.
Input Quality
Good input quality improves every result. Use the differential percentage from the same fluid sample. Do not mix blood white cells with ascitic fluid cells. Enter red blood cells only when the report gives an ascitic RBC count. If the direct PMN field is filled, the tool uses that number first. Otherwise, it calculates PMN from total cells and neutrophils.
Safe Interpretation
The interpretation labels are intentionally cautious. They point to patterns that need professional review. They do not replace bedside assessment. A patient with pain, fever, encephalopathy, low blood pressure, or worsening kidney tests should be assessed urgently. Culture reports may arrive later, so early decisions often depend on the cell count and clinical picture.
Final Review
Use the result as a structured summary, not as a final diagnosis. Enter the same units shown on the form. Review abnormal values carefully. Repeat paracentesis or further imaging may be needed in selected cases. Any patient who looks unwell needs immediate medical attention right away, even if one calculated number appears reassuring.