Cell count and differential

A normal leukocyte count (<250-500 cells/µl) is seen in cirrhosis, nephrosis and

congestive heart failure

Elevated leukocyte count: predominant

polymorphonuclear neutrophiles: bacterial peritonitis; predominantly lymphocytes:

tuberculous peritonitis: also suggests bowel perforation from the paracentesis needle.

SBP is defined by a polymorphonuclear neutrophil (PMN) count of 250/mm3 in the

ascitic fluid.

6. Gram and acid fast staining

7. Culture, with ascetic fluid inoculated directly into blood culture bottles

8. Cytologic examiniation - looking for malignancy