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Isolated Brucella peritonitis in a CAPD patient

Lale Ozisik1, Beril Akman, Bulent Huddam

  • 1Department of Internal Medicine, Baskent University Faculty of Medicine, Ankara, Turkey. laleoz@gmail.com

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|April 25, 2006
PubMed

Insights

This study reports the first case of isolated Brucella peritonitis in a patient undergoing continuous ambulatory peritoneal dialysis (CAPD). The farmer patient was successfully treated with rifampin and doxycycline.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Microbiology

Background:

  • Peritonitis is a frequent complication in continuous ambulatory peritoneal dialysis (CAPD) patients.
  • Brucellosis is an uncommon cause of bacterial peritonitis, with only one prior reported case during CAPD, which was associated with systemic brucellosis.

Observation:

  • A farmer on CAPD presented with peritonitis but lacked systemic brucellosis symptoms.
  • Serum agglutination tests and blood cultures were negative.
  • Peritoneal fluid showed a high Brucella agglutination titer (1:160), and Brucella melitensis was isolated from peritoneal fluid cultures.

Findings:

  • This case represents the first documented instance of isolated Brucella peritonitis in a CAPD patient.
  • Negative blood cultures suggest direct inoculation into the peritoneal cavity rather than hematogenous spread.
  • The patient successfully recovered with a treatment regimen including rifampin and doxycycline.

Implications:

  • Highlights the importance of considering Brucellosis in CAPD peritonitis, even without systemic signs.
  • Suggests direct inoculation as a potential transmission route in CAPD patients, particularly those with occupational exposure (e.g., farmers).
  • Demonstrates the efficacy of rifampin and doxycycline for treating isolated Brucella peritonitis in CAPD.

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