Final answer:
SBP in ascites fluid is diagnosed when an ascitic fluid PMN count is >=250 cells/mm³ and treated with intravenous antibiotics, but the condition may lead to severe complications such as septic shock and multi-organ failure.
Step-by-step explanation:
Diagnostic Criteria for SBP in Ascites Fluid & Treatment
Spontaneous Bacterial Peritonitis (SBP) is a severe complication of ascites due to cirrhosis. The diagnostic criteria for SBP include an ascitic fluid absolute polymorphonuclear leukocyte (PMN) count of >=250 cells/mm³. A positive ascitic fluid bacterial culture is also often noted, although it's not always present. SBP is associated with a high mortality rate if not treated promptly.
Treatment for SBP typically involves intravenous antibiotics such as cefotaxime or a similar third-generation cephalosporin. Albumin is sometimes administered along with antibiotics to patients with kidney impairment or high bilirubin levels. Clinicians must be vigilant as despite antibiotic treatment, patients like Barbara in the clinical focus scenario may experience a decline in clinical status, leading to conditions such as septic shock and multi-organ failure.
Treatment resolution can be challenging, as evidenced in the provided clinical scenario where anti-inflammatory drugs and drotrecogin-a were insufficient to reverse Barbara's condition, indicating the severity of her situation and the progression of hepatic and renal failure, ultimately leading to her demise.