{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T19:41:31Z","timestamp":1792352491232,"version":"4.4.0"},"reference-count":22,"publisher":"BMJ","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1994,5]]},"abstract":"<jats:p>Bacterial peritonitis presents with classic symptoms of fever and abdominal pain. Some patients, however, are completely asymptomatic. Death in the short term is considerable, especially in patients with alcoholic cirrhosis. Cystic fibrosis patients occasionally develop biliary cirrhosis and may have secondary hypersplenism, varices, and ascites. These patients should be at risk for spontaneous bacterial peritonitis. Spontaneous bacterial peritonitis is described in two patients with longstanding hepatic cirrhosis secondary to cystic fibrosis. Both had required splenectomy for complications of portal hypertension. This is a previously unreported, but potentially fatal, complication of cystic fibrosis liver disease. Early diagnostic paracentesis is essential so that appropriate acute management, including antimicrobial treatment can be started. In the long term, these patients deserve immediate paracentesis for any evidence of recurrence. Whether the patient is treated with chronic (continuous) antimicrobial prophylaxis or only receives antimicrobial treatment during periods when bacteraemia is possible (for example, dental work, bronchoscopy), it would seem reasonable in patients with cystic fibrosis to use a wide spectrum antimicrobial agent with activity against Pseudomonas aeruginosa, other common Gram negative organisms, and Staphylococcus aureus.<\/jats:p>","DOI":"10.1136\/gut.35.5.709","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"709-711","source":"Crossref","is-referenced-by-count":7,"title":["Spontaneous bacterial peritonitis in cystic fibrosis."],"prefix":"10.1136","volume":"35","author":[{"given":"C F","family":"Doershuk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R C","family":"Stern","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1994,5,1]]},"reference":[{"key":"ref_1","article-title":"of culture negative, but probable SPB,'` Runyon and Hoefs reported 18 episodes of culture negative neutrocytic ascites,' with many similarities to SBP. Subsequently, SBP and culture negative neutrocytic asites have been reported in many conditions.\"2 Patients with alcoholic cirrhosis and peritonitis have substantial inhospital mortality,3'8 with some improvement after earlier diagnosis and improved antimicrobial treatment.7","year":"1993","unstructured":"August 1993 of culture negative, but probable SPB,'` Runyon and Hoefs reported 18 episodes of culture negative neutrocytic ascites,' with many similarities to SBP. Subsequently, SBP and culture negative neutrocytic asites have been reported in many conditions.\"2 Patients with alcoholic cirrhosis and peritonitis have substantial inhospital mortality,3'8 with some improvement after earlier diagnosis and improved antimicrobial treatment.7"},{"key":"ref_2","first-page":"47287","article-title":"Septicemie porto-cave: cirrhoses du foie et septicemie a colibacille","volume":"34","author":"Caroli, J.; Platteborse, R.","year":"1958","unstructured":"Caroli J, Platteborse R. Septicemie porto-cave: cirrhoses du foie et septicemie a colibacille. Sem Hop Paris 1958; 34: 47287.","journal-title":"Sem Hop Paris"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1136\/gut.4.4.394","article-title":"Pearson DT, Read AE. Infection of ascitic fluid in patients with hepatic cirrhosis","volume":"4","author":"Kerr, D.N.S.","year":"1963","unstructured":"Kerr DNS, Pearson DT, Read AE. Infection of ascitic fluid in patients with hepatic cirrhosis. Gut 1963; 4: 394-8.","journal-title":"Gut"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"568","DOI":"10.7326\/0003-4819-60-4-568","article-title":"Spontaneous bacterial peritonitis and bacteremia in Laennec's cirrhosis caused by enteric organisms","volume":"60","author":"Conn, H.O.","year":"1964","unstructured":"Conn HO. Spontaneous bacterial peritonitis and bacteremia in Laennec's cirrhosis caused by enteric organisms. 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Med Clin North Am 1975; 59: 963-83.","journal-title":"Med Clin North Am"},{"key":"ref_7","first-page":"399","article-title":"Spontaneous bacterial peritonitis","volume":"2","author":"Hoefs, J.C.; Canawati, H.N.; Sapico, F.L.; Hopkins, R.R.; Weiner, J.; Montgomerie, J.Z.","year":"1982","unstructured":"Hoefs JC, Canawati HN, Sapico FL, Hopkins RR, Weiner J, Montgomerie JZ. Spontaneous bacterial peritonitis. Hepatology 1982; 2: 399-407.","journal-title":"Hepatology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1097\/00005792-197105000-00002","article-title":"Spontaneous bacterial peritonitis in cirrhosis: variations on a theme","volume":"50","author":"Conn, H.O.; Fessel, J.M.","year":"1971","unstructured":"Conn HO, Fessel JM. Spontaneous bacterial peritonitis in cirrhosis: variations on a theme. Medicine 1971; 50: 161-97.","journal-title":"Medicine"},{"key":"ref_9","first-page":"1262","article-title":"Portal hypertension","volume-title":"Principles and practice of gastroenterology and hepatology","author":"Hoefs, J.C.","year":"1988","unstructured":"Hoefs JC. Portal hypertension. In: Gitnick G, ed. Principles and practice of gastroenterology and hepatology. 1st ed. New York: Elsevier, 1988: 1262-6.","edition":"1st ed"},{"key":"ref_10","first-page":"545","article-title":"Spontaneous bacterial peritonitis: a prospective investigation in predominantly nonalcoholic cirrhotic patients","volume":"3","author":"Pinzello, G.; Simonetti, R.G.; Craxi, A.; Di Piazza, S.; Spano, C.; Pagliaro, L.","year":"1983","unstructured":"Pinzello G, Simonetti RG, Craxi A, Di Piazza S, Spano C, Pagliaro L. Spontaneous bacterial peritonitis: a prospective investigation in predominantly nonalcoholic cirrhotic patients. 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Philadelphia: JB Lippincott, 1987: 829-64.","edition":"6th ed"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/0002-9343(79)90491-1","article-title":"Cystic fibrosis in adults","volume":"66","author":"di Sant 'Agnese PA, Davis PB","year":"1979","unstructured":"di Sant 'Agnese PA, Davis PB. Cystic fibrosis in adults. AmJ7 Med 1979; 66: 121-32.","journal-title":"AmJ7 Med"},{"key":"ref_14","first-page":"357","article-title":"The pathological changes in the liver in cystic fibrosis of the pancreas","volume":"93","author":"Craig, J.M.; Haddad, H.; Shwachman, H.","year":"1957","unstructured":"Craig JM, Haddad H, Shwachman H. The pathological changes in the liver in cystic fibrosis of the pancreas. 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