Spontaneous bacterial peritonitis (SBP) is a common complication of ascites, with a high mortality rate reported. Listeria is a rare cause of SBP and is diagnosed by positive ascitic culture. Growth of the bacteria may take up to 4 days. Routine SBP treatment using third-generation cephalosporins will not cover Listeria, causing a delay in treatment and increase in mortality. In patients with SBP who are not improving clinically within 48 hours, it is important to rule out secondary causes of peritonitis, such as viscus perforation or intra-abdominal abscess. It is also crucial to expand antibiotic coverage. Treatment involves ampicillin with or without aminoglycosides.
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Botros et al. (2024) studied this question.
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