DOI: 10.36347/sjams.2021.v09i07.016

Pages: 1209-1214

Introduction: Ascitic fluid bacterial infection is an infection of preexisting ascites in the absence of abdominal source. Ascitic fluid bacterial infection may presents in both symptomatic and asymptomatic children with chronic liver disease (CLD). Culture negative neutrocytic ascites(CNNA) is the commonest type of infection in children with CLD. Objective: To observe the variants of ascitic fluid bacterial infection in children with CLD. Methods: Thirty five consecutive children with clinical features suggestive of CLD, aged between 2-14 years of both sexes with clinically detected ascites and admitted at the Department of Paediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU) from January 2013 through June 2013 were enrolled in this cross sectional study. Children who had features of ascitic fluid infection like l fever, abdominal pain with tenderness were categorized as symptomatic and children who had no features of ascitic fluid infection were categorized as asymptomatic children. Demographic, clinical, haematological, biochemical and ascitic fluid study were done for both symptomatic and asymptomatic children. Variants of ascitic fluid bacterial infection was identified by ascitic fluid polymorphonuclear leucocyte count and culture report. Results: Among 35 children, majority 17 (48.6%) were between 6-10 years of age group with male predominance. About 12 (34.3%) were symptomatic and among the symptomatic children 7 (58.4%) were infected and 5 (41.6%) were non-infected, 16 (45.7%) had culture negative neutrocytic ascites (CNNA) variant of ascitic fluid bacterial infection as evident by ascitic fluid polymorphonuclear leucocyte count of  250/mm3 and negative culture report. Mean ascitic fluid polymorphonuclear neutrophil count was 515177.82/HPF among infected children and 85.4770.60/HPF among non-infected children, which is statistically significant (p-0.001). Wilson’s disease was the commonest 11(30) cause of the ...