Spontaneous fungal peritonitis in cirrhosis: A cytological diagnostic alert

Abstract

Liver cirrhosis can result in several serious complications, including spontaneous peritonitis. Although bacterial peritonitis is well recognized, spontaneous fungal peritonitis (SFP) is relatively uncommon and is associated with substantial morbidity and mortality. SFP is diagnosed when fungi are isolated from ascitic fluid culture in the presence of an absolute neutrophil count of ≥250 cells/mm ³ . Ascitic fluid culture is crucial for establishing the diagnosis, while cytological examination of cell-fluid preparations enables the assessment of cellularity and differential cell counts. We report a case of SFP in a middle-aged female patient with decompensated cirrhosis, in whom Candida albicans was identified as the causative pathogen. Early recognition and prompt initiation of appropriate antifungal therapy are essential for improving the clinical outcomes.