Spontaneous bacterial peritonitis as the presenting feature in an adult with nephrotic syndrome.

4.4 mmol/l, blood urea nitrogen 28 mg/dl, creatinine3.1 mg/dl, glucose 91 mg/dl, albumin 2.2 g/dl.Spontaneous bacterial peritonitis is a serious and fre- Asparate aminotransferase (AST) and alanine amino-quent complication in childhood nephrotic syndrome transferase (ALT) were 17 U/l and 5 U/l respectively,[1–3]. This type of complication in adult nephrotic and total bilirubin was 0.1 mg/dl. There was 3+patients is; however, very rare and only three cases protein on urinalysis, and urinary sediments revealedhave been reported to our knowledge [4–6]. In haematuria and 15–20 WBC/high-power field. Totalthese cases, spontaneous bacterial peritonitis usually protein in 24-h collection of urine was 4.675 g/day.occurred when patients were either in relapse or receiv- The patient’s chest X-ray film showed no pathologicaling steroid therapy at the time of diagnosis [1]. We findings. Abdominal paracentesis showed a cloudedobserved a 28-year-old female with spontaneous bac- fluid with 688 WBC/mm3with a diVerential count ofterial peritonitis and chronic renal failure as the initial 64% neutrophils, 30% monocytes, 2% eosinophils,presentations of nephrotic syndrome. and 4% lymphocytes. Ascitic fluid culture grew