This gentleman with longstanding hepatitis C, hypertension, and diabetes presents with a temperature of 100.4 F (38 C) and mild abdominal tenderness. His wife says that he's been a little confused lately. Labs show a leukocytosis, azotemia, albumin of 2. You put in a needle and take out fluid from the belly. These fluid studies show:
Total protein 0.5
45 % neutrophils
Challenge: What's your diagnosis?
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