Spontaneous Bacterial Peritonitis is indicated by presence of _______ cells in ascitic fluid
💡 Explanation
## **Core Concept**
Spontaneous Bacterial Peritonitis (SBP) is an infection of the ascitic fluid in the absence of any obvious source of infection, such as a surgical wound or fistula. It is a complication commonly seen in patients with cirrhosis and ascites. The diagnosis of SBP is primarily made by analyzing the ascitic fluid.
## **Why the Correct Answer is Right**
The correct answer, **polymorphonuclear leukocytes (PMNs)**, is right because the presence of a high number of PMNs in the ascitic fluid is a key indicator of SBP. A count of ≥ 250 PMNs/mm³ is generally considered diagnostic for SBP. PMNs are a type of white blood cell that is typically elevated in bacterial infections, reflecting the body's acute inflammatory response.
## **Why Each Wrong Option is Incorrect**
- **Option A: Lymphocytes** - While lymphocytes can be elevated in various conditions, including infections and inflammatory diseases, they are not the primary cell type used to diagnose SBP.
- **Option B: Macrophages** - Macrophages play a role in the immune response and can be present in ascitic fluid, but they are not the specific cell type used as an indicator for SBP.
- **Option D: Eosinophils** - Eosinophils are a type of white blood cell involved in combating parasites and in allergic reactions, not typically used as an indicator for bacterial infections like SBP.
## **Clinical Pearl / High-Yield Fact**
A crucial point to remember is that SBP is a medical emergency requiring prompt antibiotic treatment. The diagnosis is primarily made by ascitic fluid analysis showing ≥ 250 PMNs/mm³, and the treatment usually involves third-generation cephalosporins as the initial empirical therapy.