Question:
Which of the following findings in ascitic fluid is diagnostic of spontaneous bacterial peritonitis?
Which of the following findings in ascitic fluid is diagnostic of spontaneous bacterial peritonitis?
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Ascitic neutrophil count crossing 250 per cubic mm defines SBP.
Updated On: Jun 24, 2026
- Neutrophils > 250/mm3
- WBC < 100/mL
- Ascitic lactate level < 25 mg/dL
- Ascitic fluid pH > 7.35
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The Correct Option is A
Solution and Explanation
Step 1: Spontaneous bacterial peritonitis (SBP) is infection of pre-existing ascitic fluid, usually in cirrhotics, without any surgically treatable intra-abdominal source. Diagnosis rests on the ascitic fluid cell count.
Step 2: An absolute polymorphonuclear (neutrophil) count of more than 250 cells/mm3 in the ascitic fluid is the accepted diagnostic threshold for SBP. It reflects an acute inflammatory process and prompts empirical antibiotics. So option (a) is correct.
Step 3: The other values are wrong as written. SBP raises total WBC, so a low WBC under 100/mL argues against it. An ascitic lactate ABOVE 25 mg/dL (not below) favours active SBP. SBP lowers ascitic pH, so a high pH above 7.35 is against infection.
Step 4: Hence the single diagnostic criterion among the choices is neutrophils more than 250/mm3.
Step 2: An absolute polymorphonuclear (neutrophil) count of more than 250 cells/mm3 in the ascitic fluid is the accepted diagnostic threshold for SBP. It reflects an acute inflammatory process and prompts empirical antibiotics. So option (a) is correct.
Step 3: The other values are wrong as written. SBP raises total WBC, so a low WBC under 100/mL argues against it. An ascitic lactate ABOVE 25 mg/dL (not below) favours active SBP. SBP lowers ascitic pH, so a high pH above 7.35 is against infection.
Step 4: Hence the single diagnostic criterion among the choices is neutrophils more than 250/mm3.
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