Understanding Spontaneous Bacterial Peritonitis (SBP)

Spontaneous bacterial peritonitis (SBP) primarily occurs in patients with cirrhosis and is driven by a multifaceted mechanism involving bacterial translocation, increased intestinal permeability, and altered immunity. Instead of directly entering ascitic fluid, bacteria typically first translocate to mesenteric lymph nodes. Studies have shown that bacterial overgrowth is prevalent in cirrhotic patients, particularly those with ascites, indicating a correlation between increased intestinal stasis and bacterial proliferation. The understanding of SBP's mechanisms shifts from a simple idea of direct translocation to a more complex route involving the lymphatic system and potential entry into the bloodstream.