Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Internal Medicine

Background: Bacterial infections are a major cause of morbidity and mortality among decompensated cirrhoticpatients (DCPs). Spontaneous bacterial peritonitis (SBP) accounts for 40%{u2013}70% of these infections. Procalcitonin (PCT) is a prohormone that has been used as a marker for the early diagnosis of SBP.Objectives: The study aims to determine the diagnostic value of serum PCT and WBC/PLT ratio in DCPs with SBP.Methods: 120 subjects divided as 40 DCPs with clinical manifestations of SBP, 40 DCPs without clinical manifestations of SBP and 40 normal controls were subjected to measurement of serum PCT, WBC/PLT ratio, other hematological parameters, abdominal ultrasound, urine analysis and chest x-ray. Only DCPs were subjected to diagnostic paracentesis (ascitic fluid sample sent to measurealbumin, total protein, glucose, LDH, PMN leukocytes counts and for culture &sensitivity).Results: Serum Procalcitonin andWBC/PLTratio were statistically significant higher in SBP patients than non SBP patients.The cutoff value of PCT for diagnosis of SBP was 485 pg/ml with sensitivity 85%, specificity 85%,+PV 85% and -PV 85 %.The AUROC was 0.938. The cutoff point for WBC/PLT ratiofor diagnosis of SBP was {u2265}0.08with sensitivity 70%, specificity 65%,+PV 71.1% and -PV 69 %. The AUROC was 0.715.Conclusion: Serum PCT can be used as diagnostic biomarkers of SBP in DCPs and should be considered in combination with WBC/PLT ratio which can significantly help in early diagnosis of SBP

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