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Peritonitis caused by Chryseobacterium meningosepticum in a patient undergoing continuous ambulatory peritoneal
Vin-Cent Wu1, Tun-Jun Tsai, Robert Wang
1Department of Internal Medicine, En Chu Kong Hospital, Taipei, Taiwan.
Abstract:
Chryseobacterium meningosepticum is rarely encountered as a pathogen causing peritonitis in adults. A 54-year-old woman who underwent continuous ambulatory peritoneal dialysis for 8 years developed peritonitis due to C. meningosepticum. Although she received intravenous antibiotics with good in vitro activity against the organism, the fever and signs of peritonitis persisted. The Tenckhoff catheter was finally removed on the 25th day of hospitalization and the fever subsided. Four isolates of C. meningosepticum recovered from 4 ascites samples drawn on the third, 13th, 18th, and 23rd hospitalization days had identical antibiograms and random amplified DNA polymorphism patterns generated by an arbitrarily primed polymerase chain reaction. Early removal of Tenckhoff catheter and appropriate antimicrobial therapy are crucial to the successful treatment of peritonitis due to C. meningosepticum.
Insights
Chryseobacterium meningosepticum peritonitis in a continuous ambulatory peritoneal dialysis patient was challenging to treat with antibiotics alone. Early removal of the Tenckhoff catheter proved crucial for successful recovery.
Area of Science:
- Infectious Diseases
- Nephrology
- Microbiology
Background:
- Peritonitis is a serious complication in patients undergoing peritoneal dialysis.
- Chryseловек meningosepticum is an uncommon cause of peritonitis, particularly in adults on long-term dialysis.
Observation:
- A 54-year-old woman with 8 years of continuous ambulatory peritoneal dialysis developed persistent peritonitis despite appropriate intravenous antibiotic therapy.
- The patient's fever and peritonitis symptoms resolved only after the removal of her Tenckhoff catheter on day 25 of hospitalization.
Findings:
- Four isolates of Chryseobacterium meningosepticum from ascites samples showed identical antibiograms and DNA polymorphism patterns, indicating a persistent infection.
- Antibiotic treatment alone was insufficient to clear the infection, highlighting potential challenges in eradicating C. meningosepticum from the peritoneal cavity.
Implications:
- Early removal of the peritoneal dialysis catheter is a critical intervention for treating Chryseobacterium meningosepticum peritonitis.
- Effective management requires a combination of appropriate antimicrobial therapy and timely device removal to ensure patient recovery.
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