الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Around 50% of patients are diagnosed with spontaneous bacterial peritonitis (SBP) upon admission, whereas it develops in the remaining patients during their hospitalization. Given the nonspecific clinical manifestations of SBP and its variability across different stages of liver disease, the diagnosis primarily relies on laboratory and microbiological evaluations. Diagnostic paracentesis and subsequent analysis of ascitic fluid are deemed the definitive methods for confirming or excluding SBP in cirrhotic patients. Ascitic fluid cultures come back negative in up to 60% of SBP patients.
Manual microscopy stands as the benchmark and most widely used technique for quantifying ascitic neutrophils, however, due to its labor-intensive and time-consuming nature. Furthermore, it is susceptible to human error and interobserver variability. This may result in higher mortality due to a delay in diagnosis and treatment. Few studies support the use of automated flow cytometric differential counts as a rapid, accurate, and improved reference method for neutrophils and other differential counts. This technique may have high linearity with manual microscopy and, thus, sensitivity and specificity close to 100%. Patients with SBP have a poor prognosis and high incidence of HRS-AKI, with mortality up to 20% when treated and higher mortality rates (˃ 80%) among untreated patients; so, the course and outcome depend on rapid diagnosis and prompt antibiotic therapy.