K65.2 Spontaneous bacterial peritonitis

Name of the Condition

• Common name(s): Spontaneous bacterial peritonitis
• Medical term: Spontaneous bacterial peritonitis

Summary

Spontaneous bacterial peritonitis (SBP) is a bacterial infection of the peritoneal fluid, typically occurring in individuals with ascites (fluid accumulation in the abdomen). This condition arises without a clear source of infection, such as a perforated organ or surgical complication, and requires prompt medical evaluation to prevent severe outcomes.

Causes

SBP is caused by bacteria entering the peritoneal cavity, often from the gut, in the presence of ascites. The infection may result from translocation of bacteria across the intestinal wall, which is more likely when the immune system is compromised or when ascitic fluid provides a favorable environment for bacterial growth.

Risk Factors

• Ascites (especially from liver cirrhosis)
• Advanced liver disease (e.g., cirrhosis)
• Compromised immune system
• Recent gastrointestinal bleeding
• Long-term antibiotic use (increasing resistance risk)
• Low protein levels in ascitic fluid

Symptoms

• Abdominal pain or tenderness
• Fever or chills
• Confusion or altered mental status
• Nausea or vomiting
• Fatigue or weakness
• Rapid heart rate

Diagnosis

Diagnosis involves analyzing ascitic fluid obtained via paracentesis, which is tested for signs of infection, such as elevated white blood cell count or positive bacterial cultures. Blood tests and imaging may also be used to assess severity and rule out other causes.

Treatment Options

• Antibiotic therapy (targeted to the identified bacteria)
• Supportive care, including monitoring for organ function
• In severe cases, hospitalization for intravenous antibiotics
• Management of underlying conditions (e.g., liver disease)

Prognosis and Follow-Up

Prognosis depends on the severity of the infection and underlying health. Early treatment improves outcomes, but recurrence is possible. Follow-up includes monitoring for infection resolution and addressing the cause of ascites to reduce future risk.

Complications

• Septic shock
• Kidney failure
• Hepatic encephalopathy
• Death (in severe or untreated cases)

Lifestyle & Prevention

• Manage underlying conditions (e.g., liver disease) to reduce ascites
• Avoid alcohol and follow dietary recommendations
• Seek prompt care for abdominal symptoms or signs of infection
• Adhere to prescribed treatments for ascites or liver disease

When to Seek Professional Help

Seek immediate medical attention if you experience severe abdominal pain, fever, confusion, or other signs of infection, especially if you have a history of ascites or liver disease.

Tips for Medical Coders

When coding for K65.2, ensure documentation supports the diagnosis of spontaneous bacterial peritonitis, including ascitic fluid analysis results and clinical findings. Note the absence of a perforated organ or surgical cause to distinguish it from other peritonitis types.