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Cell count: Normal ascitic fluid contains fewer than 500 leukocytes/ÂµL and fewer than 250 polymorphonuclear leukocytes (PMNs)/ÂµL. Any inflammatory condition can cause an elevated white blood cell count. A PMN count of greater than 250 cells/ÂµL is highly suggestive of bacterial peritonitis.
What is the cause of this patient's severe, painful ascites? Painful, severe ascites can be due to peritoneal diseases such as malignancy or tuberculosis. In such cases, however, the peritoneal fluid usually shows cells suggesting inflammation or malignancy. This patient's ascitic fluid had very few cells.