Distinguishing SBP from secondary bacterial peritonitis in patients with ascitic neutrophil count ≥250 cells/microL and nonacute abdomen

This figure provides an approach to distinguishing SBP from secondary bacterial peritonitis in adults with cirrhosis, ascites, and nonacute abdomen. Secondary bacterial peritonitis is infected ascites in the setting of an underlying intra-abdominal source of infection (eg, perforated viscus). This flowchart does not apply to patients with acute abdomen (ie, abdominal tenderness with rebound) or hemodynamical instability; such patients should be evaluated promptly, usually requiring referral to emergency department. This flowchart is intended for use with additional UpToDate content on bacterial peritonitis in patients with cirrhosis and ascites.