A 49-year-old male, chronic alcoholic presented to ER with complaints of fever, progressive lethargy and confusion for 2-3 days. On examination, Hypotension Tachycardia Distended diffusely tender abdomen Positive fluid wave The doctor advised USG of the abdomen which revealed irregular outline of liver with coarsened echotexture with gross ascites. Paracentesis of the ascites was done and sent for examination which revealed, WBC count- 1000/ microL Neutrophils – 40% All of the following are true about the most common organisms causing the above condition except: –
Correct Answer: Phenylalanine deaminase positive
Description: This is a case of spontaneous bacterial peritonitis in a patient with chronic liver disease. It is spontaneous because there is no apparent source of contamination. Neutrophil count of > 250/ microL is diagnostic. Most commonly caused by enteric gram-negative bacilli. Enterobacteriaceae Gram negative Oxidase negative Ferment glucose with acid production Reduce nitrates Phenylalanine deaminase negative MR negative VP positive Some weakly urease positive
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