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| *often abdominal paracentesis is done to test the fluid for WBC and cultures | | *often abdominal paracentesis is done to test the fluid for WBC and cultures |
| *A diagnosis of SBP is made if the polymorphonuclear cell (PMN, also referred to as neutrophils) count in the ascitic fluid is ≥250 cells/mm3, culture results are positive, and secondary causes of peritonitis are excluded | | *A diagnosis of SBP is made if the polymorphonuclear cell (PMN, also referred to as neutrophils) count in the ascitic fluid is ≥250 cells/mm3, culture results are positive, and secondary causes of peritonitis are excluded |
| *Spontaneous bacterial peritonitis is the development of a bacterial infection in the peritoneum causing peritonitis, despite the absence of an obvious source for the infection. It occurs almost exclusively in people with portal hypertension, usually as a result of cirrhosis of the liver. It can also occur in patients with nephrotic syndrome. I put in this clarification because there is a distinction between SBP and just peritonitis. --[[User:LKolesar|LKolesar]] 07:58, 2018 May 30 (CDT) | | ** culture results might be negative if antibiotics were started before the sample was taken; you can still code this with a pathogen of [[Infectious organism, unknown]] |
| | | *Spontaneous bacterial peritonitis is the development of a bacterial infection in the peritoneum causing peritonitis, despite the absence of an obvious source for the infection. It occurs almost exclusively in people with portal hypertension, usually as a result of cirrhosis of the liver. It can also occur in patients with nephrotic syndrome. I put in this clarification because there is a distinction between SBP and just peritonitis. |
| {{discussion}}
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| * I have a question many doctors put pts on antibiotics on spec for SBP even though NO tap /culture was done prior to antibiotics. Then a few days later a tap was done /the culture was negative. my question is do you code SBP /negative culture or do you only code SBP if a culture was done prior to antibiotics and the results come back positive. and or become positive during their stay in the hospital. And just ignore the fact that antibiotics were ordered for a diagnosis that could or couldnt be there.????
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| ** Any culture taken after antibiotics have already been started is not going to be helpful for the diagnosis, especially if negative. If the doctors are calling it SBP because of other clinical parameters (fever, abd pain, PD pt, ultrasounds , WBC, etc), then I would call it peritonitis if no other cause is found for the other symptoms and it is being treated. --[[User:LKolesar|LKolesar]] 13:33, 2014 October 14 (CDT)
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| *** I think the question was which entry to use as pathogen. Also, I think this question is much more general than just for Peritonitis. Is it a special case for [[No Culture Sent or Resulted]]? If so, could someone summarize this to there and link it from here? We'd want to word it to use the same words that a collector who searches for this next time would be likely to use. I would do it myself but would like someone medical to make sure I am not misunderstanding this, and you guys have a better idea what you would search for in such a situation... Ttenbergen 11:04, 2014 October 20 (CDT)
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| ***I think the data collectors know how to code a pathogen or not and if the pt has been on antibiotics prior to the culture, then usually the culture will be negative. The question was whether to code peritonitis even if the cultures are negative. This question can be asked of any infectious diagnosis. You have to look at the entire clincial picture and the certainty of the doctors in making the diagnosis. Culture results alone are inadequate to making a diagnosis for various reasons. They can affirm a diagnosis but are never a separate entity. --[[User:LKolesar|LKolesar]] 11:22, 2014 October 20 (CDT)
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| **** so we agree that this is about more than just peritonitis. I take your point about the pathogen part. So, does anyone have a suggestion how they would search for it in a way that is not DX specific? Because this question must be an FAQ and I want to make sure the answer can be found. So this is a question to anyone out there - how would you search for this answer on the wiki? Ttenbergen
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| **** Would it be appropriate to move this to [[Infections in ICD10]]? Would it still address the issue? Ttenbergen 22:24, 2018 May 29 (CDT)
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| == Alternate ICD10s to consider coding instead or in addition == | | == Alternate ICD10s to consider coding instead or in addition == |