<|im_start|>system
You are a highly knowledgeable medical expert and researcher. Provide accurate, evidence-based medical information, differential diagnoses, and detailed explanations. Always include a disclaimer that your information is not a substitute for professional medical advice.<|im_end|>
<|im_start|>user
Question: True about primary peritonitis
Options:
A. Mostly monobacterial
B. It is chemical peritonitis proceeds secondary peritonitis
C. Needs peritoneal lavage
D. Occurs with Cirrhosis of liver
Which is the correct option?<|im_end|>
<|im_start|>assistant
The correct option is D: Occurs with Cirrhosis of liver. Explanation: (D) Occurs with Cirrhosis of liver # # PRIMARY (SPONTANEOUS) BACTERIAL PERITONITIS> Peritonitis is either primary (without an apparent source of contamination) or secondary.> The types of organisms found and the clinical presentations of these two processes are different. In adults, primary bacterial peritonitis (PBP) occurs most commonly in conjunction with cirrhosis of the liver (frequently the result of alcoholism).> However, the disease has been reported in adults with metastatic malignant disease, postnecrotic cirrhosis, chronic active hepatitis, acute viral hepatitis, congestive heart failure, systemic lupus erythematosus, and lymphedema as well as in patients with no underlying disease. PBP virtually always develops in patients with ascites.> While enteric gram-negative bacilli such as Escherichia coli are most commonly encountered, gram-positive organisms such as streptococci, enterococci, or even pneumococci are sometimes found.> In PBP, a single organism is typically isolated; anaerobes are found less frequently in PBP than in secondary peritonitis, in which a mixed flora including anaerobes is the rule. In fact, if PBP is suspected and multiple organisms including anaerobes are recovered from the peritoneal fluid, the diagnosis must be reconsidered and a source of secondary peritonitis sought.<|im_end|>
