Spontaneous bacterial peritonitis (SBP) is a common cause of morbidity and mortality in patients with advanced cirrhosis and
portal hypertension. While gram-negative rods and
Enterococcus species are the common offending organisms,
Salmonella has also been recognized as a rare and atypical offending organism. Atypical features of
Salmonella SBP include both its occurrence in cirrhotic patients with immunosuppressive state and its lack of typical neutroascitic
response. Diagnosis is often delayed as it requires confirmation from ascitic fluid culture. We report a case of
Salmonella SBP occurring in a patient with decompensated cryptogenic cirrhosis with concurrent low-grade non-Hodgkin lymphoma and prior
treatment with rituximab. Physicians should be aware of the atypical presentation, especially in cirrhotic patients who are
immunosuppressed.
Keywords Spontaneous bacterial peritonitis - Rituximab - Live donor liver transplant - Cirrhosis