Combined spontaneous bacterial empyema and peritonitis in cirrhotic patients with ascites and hepatic hydrothorax.

Background And Study Aims: Spontaneous bacterial empyema (SBEM) is an underestimated condition in patients with ascites and hepatic hydrothorax with a high mortality. This study aimed to find whether spontaneous bacterial peritonitis (SBP) is a prerequisite for SBEM.

Patients And Methods: 3000 HCV-related cirrhotic patients with ascites and hydrothorax were screened for the presence of SBP (ascitic fluid neutrophils >250/mm) and SBEM (positive pleural fluid culture and neutrophils >250/mm or negative pleural fluid culture and neutrophils >500/mm with no evidence of pneumonia/parapneumonic effusion on chest radiograph or CT).