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INCIDENCE OF CULTURE NEGATIVE NEUTROCYTIC ASCITES IN PATIENTS WITH CHRONIC LIVER DISEASE

Dr Qudsia Mujeeb, Dr Rana Sajid Ali, Dr Maheen Rana

Higher morbidity and mortality occur in patients with liver cirrhosis as a result of ascitic fluid infection. There are two types of ascitic fluid infections, namely spontaneous bacterial peritonitis (PAS) and negatively cultured neutrocytic ascites (CNNA). By definition, in the culture negative neutrocytic ascites (CNNA), the number of polymorphonuclear cells is equal to or greater than 250 / mm3 and there are no source of infection in the abdomen. Secondary causes such as pancreatitis, peritoneal cancer, tuberculous peritonitis must be omitted. CNNA is a type of ascitic fluid infection first described in 1984. SBP has been shown to have the same prognostic, clinical and therapeutic properties. However, CNNA has been shown to have lower mortality compared to spontaneous bacterial peritonitis. Third-generation cephalosporin is considered the most effective drug in the treatment of SBP. The following measures are helpful used for the CNNA diagnosis (1) neutrophil count above 250/mm3 (2) culture negative ascetic fluid (3) absence of any intra-abdominal infection (4) no antibiotic received in the last one month (5) no clinical evidence of pancreatitis.. Due to the increase in mortality, it is recommended that CNNA be treated with antibiotics as soon as possible. Aim: The purpose of our research was to determine the occurrence of CNNA in patients with chronic liver disease. Place and Duration: In the Department of Gastroenterology, Mayo Hospital Lahore for one-year duration from January 2018 to December 2018. Methods: Patients with EPC presenting ascites at the Lady Reading Hospital, Gastroenterology Department, Medical Education Institutions. In most cases, cirrhosis is caused by hepatitis C followed by hepatitis B and so on. Most patients were in the Child-Pugh class C stage and sampling was performed using the non-probability consecutive sampling technique. The study involved two hundred and fifty patients (150 men and 100 women). Culture negative neutrocytic ascites was detected in 150 (60%) patients. There were no significant differences in CNNA prevalence in age, sex and duration of CLD. Conclusion: 60% (150 of 250) of patients with chronic liver disease who were admitted in the hospital were found to have negative neutrocytic ascites. Key words: culturally negative neutrocytic ascites, chronic liver disease, portal hypertension.

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