Background: Spontaneous bacterial peritonitis (SBP) is a life-threatening infection in patients with cirrhosis. Depending on the clinical setting, the prevalence and mortality rates of SBP in cirrhosis range between 1.5-30% and 10-46%, respectively. The purpose of this study was to assess the yearly trend in SBP prevalence, length of stay and mortality among hospitalized cirrhosis [...]

Background: Standard risk prediction tools including the quick-Sequential Organ Failure Assessment (qSOFA) have been validated using in-hospital outcomes (mortality [Died-Hosp] or intensive care unit stay >72 hours [ICU72]). Yet, risk models are often applied to predict outcomes beyond hospitalization, and it is unclear what effect outcome selection has on model performance. We derived independent robust [...]

Background: Ceftriaxone or cefotaxime has been the drug of choice to treat spontaneous bacterial peritonitis (SBP) for many years, but little is known about microbiology, resistance rate to cephalosporines, and clinical outcomes over the last few decades. Our study aimed to describe the clinical and microbiological characteristics of culture-positive SBP at University of Kentucky Hospital. [...]

Background: Spontaneous Bacterial Peritonitis (SBP) is associated with high mortality.  A recent article[1] showed that, in the setting of SBP, delayed paracentesis was associated with increased mortality.  Because of the clinical ramifications of this association, we attempted to recreate this finding using our local patient population. Methods: Similar to the study that prompted this inquiry, [...]

Background: Spontaneous bacterial peritonitis (SBP) is a commonly encountered complication of end stage liver disease that carries a high morbidity and mortality. Risk factors for SBP are defined by the American Association for the Study of Liver Diseases (AASLD) as a prior history of SBP, active gastrointestinal bleeding, and low ascites total protein (< 1.5 [...]

Case Presentation: A 61-year-old male with a past medical history of pancreatic and renal transplants on chronic immunosuppression presented with a six-day history of watery diarrhea. He also reported fever, abdominal pain, and noted a family member also developed a similar diarrhea after a pork dinner. His vital signs were remarkable for fever (101.8 F) [...]

Case Presentation: 54 years old man with a history of hypertension was hospitalized due to elevated BUN/creatinine of 33/4.6 mg/dL and Hb of 9.9 mg/dL (baseline 15). He endorsed dyspnea on exertion, anorexia and weight loss of 15 pounds in 6 months. One month ago, he was treated for acute bronchitis with levofloxacin and was [...]

Case Presentation: A 38 year-old-male with cirrhosis from hepatitis B and C complicated by recurrent ascites, previous spontaneous bacterial peritonitis (SBP), and recurrent hepatic hydrothorax requiring transjugular intrahepatic portosystemic shunt presented with two days of increasing dyspnea at rest. He had recently been nonadherent with SBP prophylaxis and diuretics. Laboratory findings revealed leukocytosis of 17,500k/uL, [...]

Case Presentation: A healthy 22-year-old woman presented to the ED with five days of fevers, dry cough, dyspnea and right-sided pleuritic chest pain. Lab work and a CXR were unremarkable. A nasal swab diagnosed Influenza B and she was discharged with Oseltamivir, which she did not take. Two days later, the patient returned with progressive [...]

Case Presentation: A 59-year-old male with a bicuspid aortic valve presented to the hospital with a syncopal event. One week earlier, a transesophageal echocardiogram (TEE) done for preoperative assessment had confirmed a heavily calcified bicuspid aortic valve and severe aortic insufficiency. He also reported 2 months of night sweats without fevers, 25-pound weight loss, and [...]