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Peritonitis caused by Mycobacterium kansasii in a patient undergoing continuous ambulatory peritoneal dialysis

M Giladi1, B E Lee, O G Berlin

  • 1Department of Medicine, UCLA School of Medicine.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|June 1, 1992
PubMed

Insights

Mycobacterium kansasii caused peritonitis in a continuous ambulatory peritoneal dialysis (CAPD) patient. Early diagnosis and tailored antimicrobial therapy, including higher-dose isoniazid, are crucial for successful treatment.

Area of Science:

  • Infectious Diseases
  • Nephrology
  • Microbiology

Background:

  • Continuous ambulatory peritoneal dialysis (CAPD) is a treatment for end-stage renal disease.
  • Peritonitis is a serious complication of CAPD, often caused by common bacteria.
  • Atypical mycobacterial infections are rare but significant causes of CAPD peritonitis.

Observation:

  • A 62-year-old female CAPD patient presented with clinical peritonitis.
  • Mycobacterium kansasii was identified in peritoneal fluid, biopsy, and Tenckhoff catheter.
  • Standard susceptibility testing indicated isoniazid resistance, but higher concentrations showed in vitro inhibition.

Findings:

  • This is the first reported case of CAPD-associated peritonitis caused by Mycobacterium kansasii.
  • The patient achieved clinical improvement with a combination therapy of isoniazid and rifampin.
  • Catheter removal was also a critical component of the treatment regimen.

Implications:

  • Highlights the importance of considering mycobacterial infections in refractory or atypical CAPD peritonitis cases.
  • Underscores the need for quantitative in vitro susceptibility testing for optimizing antimicrobial therapy.
  • Suggests that higher isoniazid concentrations may be effective against certain resistant strains of M. kansasii.

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