Cerosis is an immunocompromised state.

And the focus of this talk, it's going to be on the all too common infection that some

serotics get called spontaneous bacterial peritonitis.

It's an infection that occurs in acidic fluid in the setting of portal hypertension,

and both the ascites in the portal hypertension occur

because of the cirrhosis and usually it's monomicrobial so aerobic gram-negative

bacilli like e coli klebsiella they're responsible for more than two-thirds of the cases

of spontaneous bacterial peritonitis, which I'll just call

SBP from here on out. And while the majority of cases of SBP are caused by these gram-negative

enteric organisms like E. coli, like Klebsiella, for unclear reasons to me in recent years,

the proportion of SPP that's being caused by gram-positive

cox size such as streptocococcus pneumonia, staphycoccus species, and anarococcus species is increasing.

And there can be some weird organisms that cause SPP. So one of my best friends and a colleague

in my group texted me after the first lecture to make sure that

Vibriovolnificus gets its due props.

This Vibio-Infection, Vibrio-Vulnificus occurs after eating raw or undercooked shellfish, especially

oysters, and Vibio-Fulnificus is tremendously more likely to spread into the bloodstream in people with compromised

immune systems, especially those with chronic liver disease. It's an important organism in this

sense that more than 90% of the deaths associated with eating seafood in the United States occur from that organism,

yet at the same time, seafood-related deaths are uncommon, and therefore seeing sepsis

from vibrio-fulnificus is uncommon for most of us to see.

And I should note that even though Vibrio-Fulnificus is responsible for more deaths than other organisms from seafood,

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